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M 



I 



^1 





special Attention is called to the following : 

The next Annual Meeting of the Medical Society 
OF New Jersey will be held at Lake Hopatcong, on 
the fourth Tuesday in June, 1894. 

Each District Society is entitled to three Delegates 
at large and one additional for every ten members. 

The District Reporters are requested to send their 
reports to the Chairman of the Standing Committee 
at least three we^iks before the time of the Annual 
Meeting. 

The Standing Committee would remind Reporters 
that their reports are to be published in the volume of 
Transactions, and should therefore be carefully pre- 
pared, and that names and medical terms especially 
should be distinctly written. Reports from other 
physicians should be incorporated in their own report. 

The assessment for the year 1894 upon the District 
Societies is one dollar for each member. 

The Secretaries of the respective Societies are 
requested to send a list of Delegates and Members, 
with Post Office addresses, to the Recording Secre- 
tary, Dr. Wm. Pierson, Orange, at least ten days 
before the Annual Meeting. 



TRANSACTIONS 



OF THE 



Medical Society 



OF 



NEW JERSEY. 



1893. 



L. 7. Hardham, Printer, 243 6* 245 Market Street ^ Newark, N. J. 

1893. 



OFFICERS, 1893. 

PRESIDENT, 
JOHN G. RYERSON, .... Boonton. 

VICE-PRESIDENTS. 

O. H. SPROUL, Flemington. 

WILLIAM ELMER, Jr., - - . - Trenton. 
T. J. SMITH, Bridgeton 

CORRESPONDING SECRETARY, 
E. L. B. GODFREY, - . 1 . . Camden. 

RECORDING SECRETARY. 
WILLIAM PIERSON, Orange. 

TREASURER, 
ARCHIBALD MERCER, .... Newark. 

STANDING COMMITTEE, 

D. C. ENGLISH, Chairman, - - New Brunswick. 

H. W. ELMER, Bridgeton. 

WM. H. ISZARD, Camden. 



FELLOWS. 



All persons who shall have been, or may hereafter be President of the Society, shall rank as 
Fellows, and be entitled to all the privileges of delegated members. 

Act of Incorporation^ Sec. x. 
The dates represent the year of official service as President. 
Those marked thus (*) are deceatsed. 



♦Charles Smith 

♦Matt. H. Williamson. 

♦Samuel Forman 

♦John Van Cleve 

♦Lewis Dunham 

♦Peter L Stryker 

♦John Van Cleve 



♦Robert McKean 1766 

♦William Burnett 1767 

♦John Cochran 1768 

♦Nathaniel Scudder 1770 

♦Isaac Smith 1771 

♦James Newell 1772 

♦Absalom BAINBRIDGE....1773 

♦Thomas Wiggins 1 774 ♦Lewis Condict 

♦Hezekiah Stites 1775 ♦James Lee ^ 

 ♦William G. Reynolds.. 

♦John Beatty 1782 ♦Augustus R. Taylor... 

♦Thomas Barber 1783 ♦William B. Ewing 

♦Lawrence Van Derveer. 1 784 ♦Peter L Stryker 

♦Moses Bloomfield 1785 ♦Gilbert S. Woodhull.. 

♦William Burnett 1786 ♦Wm. D. McKissack 

♦Jonathan Elmer 1787 ♦Isaac Pierson 

♦James Stratton 1788 ♦Jeptha B. Munn 

♦Moses Scott 1789 ♦John W. Craig 

♦John Griffith 1790 ♦Augustus R. Taylor. . . 

♦Lewis Dunham 1791 ♦Thomas Yarrow 

♦Isaac Harris 1792 *Fitz Randolph Smith . . 

♦Elisha Newell 1795 ♦William Forman 

♦Jonathan F. Morris 1 807 ♦Samuel Hayes 

♦Peter I. Stryker 1808 ♦Abm. P. Hageman 

♦Lewis Morgan 1809 *Henry Van Derveer. .. 

♦Lewis Condict 1810 ♦Lyndon A. Smith 



811 
812 
814 

815 
816 

817 
818 
819 
820 
821 
822 
823 
824 
825 
826 
827 
828 
829 
830 

831 
832 

833 

834 

835 
836 

837 



MEDICAL SOCIETY OF NEW JERSEY. 



*Benj. H. Stratton 1838 

♦jabez g. goble 1839 

♦Thomas P. Stewart. . ... 1840 
♦Ferdinand S. SCHENCK..1841 

♦Zachariah Read 1842 

♦Abraham Skillman 1843 

♦George R. Chetwood. . . 1844 

♦Robert S. Smith 1845 

♦Charles Hannah 1846 

♦Jacob T. B. Skillman 1847 

Samuel H. Pennington. 1848 

♦Joseph Fithian 1849 

♦Eli as J. Marsh 1 850 

♦John H. Phillips 1851 

♦Othn'l H. Taylor 1852 

♦Samuel Lilly 1853 

♦A. B. Dayton 1854 

♦J. B. Coleman 1855 

♦Richard M. Cooper 1856 

♦Thomas R yerson 1857 

♦Isaac P. Coleman 1858 

♦John R. Sickler 1859 

♦Wm. Elmer i860 

♦JNO. Blane 1861 

♦JNO. Woolverton 1862 

♦Theo. R. Varick 1863 

Ezra M. Hunt 1864 

♦Abram Coles 1865 



♦Benjamin R. Bateman.. . 1866 

Jno. C. Johnson 1867 

♦Thomas J. Corson 1868 

♦William Pierson 1869 

♦Thomas F. Cullen 1870 

♦Charles Hasbrouck 1871 

Franklin Gauntt 1872 

♦T. J. Thomason 1873 

♦G. H. Larison 1874 

♦Wm. O'Gorman 1875 

♦Jno. V. SCHENCK 1876 

Henry R. Baldwin 1877 

John S.Cook 1878 

Alex. W. Rogers 1879 

♦Alex. N. Dougherty 1880 

♦Lewis W. Oakley 1 88 1 

♦John W. Snowden 1882 

♦Stephen Wickes 1883 

P. C. Barker 1884 

♦Joseph Parrish 1885 

Charles J. Kipp 1886 

John W.Ward 1887 

H. Genet Taylor 1888 

♦B.A.Watson 1889 

♦JAS. S.Green 1890 

Elias J. Marsh 1891 

George T. Welch 1892 



HONORARY MEMBERS. 



-♦- 



*David Hosack. New York 1827 

♦J.W.Francis 1827 

♦John Condict, Orange 1830 

♦Usher Parsons, Rhode Island 1839 

♦Reuben D. Murphy, Cincinnati 1839 

♦Alban G. Smith, New York 1839 

♦Willard Parker, New York 1842 

♦Valentine Mott, New York 1843 

♦Jonathan Knight, New Haven 1848 

♦Nathaniel Chapman, Philadelphia 1848 

♦Alexander H. Stephens, New York 1848 

♦John C. Warren, Boston 1849 

♦Lewis C. Beck, New York 1 850 

♦John C. Torrey, New York 1850 

♦George B. Wood, Philadelphia 1853 

H. A. BUTTOLPH, Short Hills, N. J 1854 

ASHBEL Woodward, Franklin, Conn 1 861 

♦Thomas W. Blatchford, Troy, N. Y 1861 

♦Jeremiah S. English, Manalapan, N. J 1867 

♦Stephen Wickes, Orange, N. J 1868 

♦S. O. Vanderpool, Albany, N. Y 1872 

♦Joseph Parrish, Burling^ton, N. J 1872 

♦Ferris Jacobs, Delhi, N. Y 1872 

C. A. LiNDSLEY, New Haven, Conn 1872 

Wm. Pepper, Philadelphia 1 874 

S. WiER Mitchell, Philadelphia 1876 

Cyrus F. Brackett. Princeton, N. J 1880 

♦Joseph C. Hutchinson, Brooklyn, N. Y 1880 

Thomas Addis Emmett, New York 1884 

Isaac E. Taylor, New York 1884 

+D. Hayes Agnew, Philadelphia 1886 

♦Jos. Leidy, Philadelphia 1886 

Frederick S. Dennis, New York 1893 

John H. Ripley, New York 1893 

Virgil P. Gibney, New York 1893 



PERMANENT DELEGATES. 



Henry C. Neer, 
James M. Ridge, 
Alex. Marcy, 
V. M. D. Marcy, 
W. H. C. Smith, 
C. F. J. Lehlbach, 
Charles Young, 
John H. J. Love, 
Arthur Ward, 
Joseph C. Young, 
Isaac S. Cramer, 
J. D. Mcgill^ 
J. Howard Pugh, 
Alonzo Pettit, 
E. B. Silvers, 



P. A. Harris, 
George E. Reading, 

B. A. Waddington, 
Robert F. Chabert, 
Cornelius Shepard, 
Charles H. Dunham, 

C. H. Andrus, ' 
Henry Mitchell, 
Henry C. Cooke, 
I, W. Condit, 
John Stiger, 

W. B. Johnson, 
H. G. Wagnor, 
Sidney Strailey, 
John H. Griffith. 



Members of District Medical Societies 

REPRESENTED AT THE 

ANNUAL MEETING, 1893. 



it 



*i 



ATLANTIC COUNTY. 

(District Society organized June 7, x88o.) 

B.C.Ftnnington, Pres,, A i/a ft //cCi'iy P. Marvel, Atlantic City 
T. P. Waters, V, Pres., Absecon T. H. Boysen, Egg Harbor City 

E. C. Chew, Sec*y^ Atlantic City Job Somers, Linwood 

E. L. Reed, Treas,, " Julius Kaemmerer, Atlantic City 

H. C. James, Rep.y Mays Landing E. H. Madden, Absecon 

G. P. Gehring, Baker sville W. M. Pollard, Atlantic City 
E. P. Williams, Atlantic City J^B. Thompson, 
J. A. Joy, Atlantic City A. D. Cuskaden, 

B. Reed, ** Ed. North, Hammonton 
W. M. Powell, 

No. Members, 19. 

BERGEN COUNTY. 

(District Society reorganized February a8, 1854.) 

Jas. B. W. Lansing, Pres,, Tenafiy J. J. Haring, Tenafly 

MartinTygert, V,Pres„ Rutherford Lewis Parsells, Closter 

Da.yidSt,]ohny Treas.,//ackensack Sam'l J. Zabriskie, Westwood 

Dan'l A. Currie, Secy, Englewood Eugene Jehl, Park Ridge 
Sam'l E. Armstrong, D, R., J. W. Simpson, Schraalenburgh 

Rutherford G. H. McFadden, Hackensack 

Henry C. Neer, Park Ridge Henry M. Hooper, Rutherford 

M. S. Ayers Fairview Chas. Calhoun, " 

Geo. E. Brown, Hackensack Wm. L. Vroom, Ridgewood 
Joseph Huger, Fort Lee Wm. E. Trautwein, Lyndhurst 



lO 



MEDICAL SOCIETY OF NEW JERSEY. 



J. W. Terry, 
John A. Wells, 
J. T. De Mund, 



Englewood Jas. W. Proctor, Englewood 

Hardy M. Banks, 
Ridgewood A. L. A'andevere, Hackensack 

HONORARY MEMBERS. 



L. D. Tady, M. D., Orange, N, J. Fred'k Morris, M. D., Nonvood 
No. Members, 25. 

BURLINGTON COUNTY. 

(Society organized May 19, 1829. Meets third Tuesday in Jan., April, June and Oct.) 



N. N. Stokes, Pres., Moor est own 
R. H. Parsons, V. P. and 

Censor, Mt. Holly 
A. W. Taylor, Sec'y, Beverly 

E. Hollingshead, Treas.,Pemberfn 
W. H. Shipps, Hist., Bordentown 
Wm. L. Martin, Censor, Rancocas 
B.W.Macfarland, *' Bordentown 

F. A. Gauntt, 
J. D. Janney, 
Wm. P. Melcher, 
W. C. Parry, 
R. C. Harrington, 



Burlington 

Cinnaminson 

Mt. Holly 



Wm. Chamberlain, 
Franklin Gauntt, 
W. E. Hall, 
J. Howard Pugh, 
Irene D. Young, 
Lewis L. Sharp, 
J. Reeve, 
D. J. Van Mater 
T. T. Price, 
Alex. Marcy, 
Alex. H. Small, 
Joseph Stokes, 
Frank G. Stroud, 



Mt, Holly 
Burlington 



«( 



(( 



Bordentown 
Medford 



<< 



Columbus 

Tuckerton 

Riverton 

Riverside 

Moorestown 



CONTRIBUTING MEMBER. 

William Martin, Bristol, Penn. 



Geo. Goodell, 
E. P. Townsend, 

No. Members, 25. 



HONORARY MEMBERS. 

Sykesville Chas. H. Thomas, 
Camden i8oy Chestnut St., Phila, Pa. 



CAMDEN COUNTY. 

(Society organized August 14, 1846. Meets second Tuesday in Feb., May and Nov.) 

H. F. Palm, Pres,^ Camden John K. Bennett, Gloucester 

E. P. Townsend, V, Pres., " O. W. Braymer, Camden 

Geo. T. Robmson, Treas., " J. S. Baer, " 

A. T. Dobson, Secy, '* W. T. Collins, 



<4 



MEDICAL SOCIETY OF NEW JERSEY. 



II 



Gloucester 
Camden 



Blackwood 

Gloucester 

Camden 



J. R. Stevenson, Censor and 

Hist., Haddonfield 
H. E. Branin, Censor, Blackwood 
Alex. Marcy, " Camden 

H. Genet Taylor, " 
Dowling Benjamin, " 

Duncan W. Blake, 
Conrad G. Hoell, 
George W. Henry, 
Jos. E. Hurff, 
J. J. Haley, 
W. H. Ireland, 
W. H. Iszard. 
W. S. Jones, 
W. B. Jennings, 
C. H. Jennings, 
Henry Jarrett, 
W. Kensinger, 
Benj. S. Lewis, 
John F. Leavitt, 
Alex. Mecray, 
J. W. Marcy, 
Alex. McAlister, 
W. F. H. Osmun, 

No. Members, 56. 



Haddonfield 

Merchantsville 

Camden 

Cramer s Hill 

Camden 



Merchantsville 
Camden 



J. W. Donges, 
H. H. Davis, 
W. A. Davis, 
N. Davis, 
Joel W. Fithian, 
E. L. B. Godfrey, 
Onan B. Gross, 
W. R. Powell, 
Sophia Presley 
J. M. Ridge, 
C. M. Schellinger, 

C. H. Shivers, 
Jas. Stanton, 

H. A. M. Smith, 

D. M. Stout, 
Daniel Strock, 
W. Shaeffer, 
H. H. Sherk, 

E. Tomlinson, 
E. B. Woolston, 
J. O. White. 

J. H. Wills, 

Jas. A. Walmsley, 

W. A. Westcott, 



Camden 



•« 



(( 



{< 



<< 



ti 



Haddonfield 

Camden 

Gloucester 

Berlin 

Camden 



<( 



Cramer's Hill 

Gloucester 

Marlton 

Camden 



<< 



Gloucester 
Berlin 



CAPE MAY COUNTY. 

(Society organized March 12, 1885. Meets first Thursday in April and Nov.) 



^ .%.\.t2Jt\\Vi%,Pres,, Cape May City Eugene Way, 

J. C. Marshall, V. Pres., Tuckahoe John Wiley, 

R. Marshall, Treas , " B. T. Abbott, 

W. A. Lake, Secy and Rep,, P. M. Way, 

Green Creek C. M. Gandy, 

Emlen Physick, Censor, J. E. Prior, 

Cape May City James Mecray, 

]\}}i[w%^ 2i^, Censor, Cape May CH, I. M. Downes, 

V. M. D. Marcy, Cape May City Coleman F. Learning, " 

No. Members, i6. 



Dennisville 

Cape May C. H. 

Tuckahoe 

South Seaville 

U. 5. Army 

Ocean City 

Cape May City 

Cape May C. H, 



12 



MEDICAL SOCIETY OF NEW JERSEY. 
CUMBERLAND COUNTY. 



(Society organized Dec. 8, i8x8.) 



<( 



it 



J. C. Applegate, Pres., Bridgeton 

W. D. Straughn, V. Pres., Fair ton 

Jos. Sheppard, Treas., Bridgeton 

H. W. Elmer, Sec^y, 

Matt. K. Elmer, Rep.y 

W. H. C. Smith, MillviUe 

Jona S. Whitaker, ** 

W. L. Newell, 

T. J. Smith, 

J. C. R. Thompson, 

Chas. H. Dare, 

David H. Oliver, 

No. members, 24. 



Bridgeton 



Bridgeton 
Vineland 



Jos. Tomlinson, 

Arthur Dare, 

Oscar H. Adams, 

Waldo F. Sawyer, 

Chas. R. Wiley, 

Ed. H. Bidwell, 

Chas. W. Wilson, 

S. M. Snyder, 

Ephm. Bateman, 

J. Rulon Dare, Deerfield Street 

S. M. Wilson, Leesburg 

S. J. Day, Port Norris 



(t 



(( 



<< 



Greenwich 
Cedatville 



ESSEX COUNTY. 



(Society organized June 8, 1816. Annual Meeting first Tuesday in April.) 



G. A.VanWagenen, Pres,y Newark 
Joseph C. Young, V, Pres., ** 
Archibald Mercer, Secy, 
Charles D. Bennett, Treas,, 
Theodore W. Corwin, Rep , " 
William B. Arnold, Orange 

Charles H. Bailey, Bloomfield 



<< 



4< 



Aaron K. Baldwin, 
George Bayles, 
Herman C. Bleyle, 
John H. Bradshaw, 
Rudolph Braun, 
James S. Brown, 
John D. Brumley, 
Walter R. Bruyere, 
Edwin L. Burns, 
Robert L. Burrage, 



Newark 
Orange 

Newark 
Orange 

Newark 
Montclair 

Newark 



<< 



ii 



<( 



Carl Battner, Orange 

William E. Carroll, Newark 

Levi W. Case, Montclair 

Talbot R. Chambers, E, Orange 

William J. Chandler, 5. Orange 

J. Henry Clark, Newark 

Henry L. Coit, 

Everit P. Cortright, 

Joseph A. Corwin, 

H. Bedell Crane, 

Wm. H. K. Davis, East Orange 

Rich'd G. P. Dieffenbach, Ne%vark 

Daniel M. Dill, 

William S. Disbrow, 

John Dennis, 

Arthur C. Dougherty, 

Charles F. Duffy, 



<( 



<( 



<< 



<( 



Ii 



(( 



<( 



<t 



(( 



MEDICAL SOCIETY OF NEW JERSEY. 



Newark 



it 



t( 



<( 



(( 



t* 



<< 



<< 



John L. Duryee, 

Wells P. Eagleton, 

David J. Edwards, 

£mma W. Edwards, 

Thomas P. Edwards, 

Julius Egge, 

David E. English, Millburn 

Thomas Dunn English, Newark 

James Elliott, " 

Joseph F. Fewsmith, " 

Thomas S. Fitch, Orange 

Richard P. Francis, Montclatr 

Albert Frey, Newark 

Ruel S. Gage, 

Robert F. Gillin, 

William Glatzmayer, 

William B. Graves, East Orange 

Thomas N. Gray, " 

Charles W. Hagen, Newark 

Joseph F. Hager, " 

Albert J. Hahn, 

Levi W. Halsey, Montclatr 

Ella Haines, Newark 

Edward H. Hamill, 

Charles W. Harrison, Caldwell 

Thomas W. Harvey, Orange 

E. Zeh Hawkes, Newark 

Joseph H. Haydon, '* 

Hugh C. Hendry, 

Henry T. Herold, 

Herman C. H. Herold, 

Peter V. P. Hewlett, 

Livingston S. Hinckley, 

James S. Hoffman, 

Edgar Holden, 

L. Eugene Hollister, 

William H. Holmes, Orange 

Charles L. Ill, Newark 

Edward J. Ill, 



13 



Newark 



(< 



<i 



<< 



(< 



it 



ti 



(( 



it 



t( 



(( 



it 



Elias P. Iliff, 
John E. Janes, 
Jotham C. Johnson, 
William M. Johnson, 
George R. Kent, 
Charles J. Kipp, 
Henry A. Komemann, " 

Charles Lehlbach, " 

Charles F. J. Lehlbach, " 

John H. J. Love, Montclair 

Thomas W. Loweree,' Newark 
Ernest M. Lyon, " 

James M. Maghee, " 

William H. McKenzie, Orange 
William H. Martland, Newark 
Henry E. Mathews, Orange 

Sarah R. Mead, Newark 

Franklin L. Meyer, '* 

Andrew M. Mills, 
Winthrop D. Mitchell, 
Frederick C. Nadler, 
Emanuel D. Newman, 
Richard C. Newton, Montclair 
Joseph D. Osborne, Newark 

Charles B. Parker, " 

Edward E. Peck, Caldwell 

Samuel H. Pennington, Newark 
William Pennington, Irvington 
Thomas F. Phelan, Orange 

William Pierson, " 

John W. Pinkham, Montclair 
William Rankin, Jr., Newark 

Joshua W. Read, 
Philip Ricord, 
Charles D. Ripley, 
Samuel E. Robertson, 
Manning N. Robinson, 
Wm. D. Robinson, East Orange 
Hugh P. Roden, Newark 



<< 



<( 



(t 



(< 



(( 



(( 



14 



MEDICAL SOCIETY OF NEW JERSEY. 



George W. Rolerfort, 
Mefford Runyon, 
Henry H. Rusby, 
Charles A. Schureman, 
Emanuel Schwartz, 
Edward Sealy, 
William F. Seidler, 
Marco Seidman, 
M. Herbert Simmons, 
Daniel M Skinner, 
Anna L. Smith, 

D. Winans Smith, 

E. Fayette Smith, 
Lott Southard, 
Robert G. Stanwood, 
Joseph W. Stickler, 
Frank O. Stockton, 
Joseph S. Sutphen, 
Robert M. Sutphen, 
Theron V. Sutphen, 

J. Francis E. Tetreault, 
Frederic W. Thum, 
Henry A. Towle, 

No. Members, 157. 



Newark 



<< 



(( 



Orange 

Belleville 

Montclair 

Newark 



(< 



Orange 
Newark 



<< 



Orange 
Newark 



Charles F. Underwood, Newark 

M. H. Cash Vail, Vailsburg 

George N. Wait, Newark 

David L. Wallace, 

Henry J. F. Wallhauser, 

Arthur Ward, 

Aaron C. Ward, 

Edwin M. Ward, 

Leslie D. Ward, 

William S. Ward, 

Walter S. Washington, 

Frederick Webner, 

Henry D. White, 

W^illiam H. White, Bloomfield 

Henry B. Whitehome, Verona 

George W. Wilkinson, 

Charles H. Winans, 

Henry M. Woolman, 

Edward E. Worl, 

James T. Wrightson, 

Charles Young, 

Charles M. Zeh, 



*< 



«( 



Nutley 



Newark 

Belleville 

Newark 



GLOUCESTER COUNTY. 

(Society organized December, 1818.) 



H. G. Buckingham, Pres., Clayton 
Geo. E. Reading, Secy and 

Treas., Woodbury 
George W. Bailey, 
George C. C. Laws, 
Samuel Fisler, 
J. Gaunt Edwards, 
Howard A. Wilson, 
Harry A. Stout, 
Henry B. Diverty, 

No. members, i8. 



Henry H. Clark, Woodbury 

Samuel F. Ashcraft, Mullica Hill 
E. Z. Hillegass, 

Eugene T. Oliphant, Bridgeport 
Thomas Lee, 

Luther M. Halsey, Williamstown 
** Luther F. Halsey, 

Woodbury James Hunter, 
M. J. Luffbary. 



Paulsboro 
Clayton 



MEDICAL SOCIETY OF NEW JERSEY. 



15 



HUDSON COUNTY. 

(Society organized October i, 1851.) 



John Nevin, Pres., Jersey City 
F. M.Corvvin, V. Pres.,BergenPoint 
John J. Broderick,5,^^y, JerseyCity 
Matthew J. Smith, Treas.Moboken 



J. A. Exton, Rep., 
G. K, Dickinson, 
Benj. Edge, 
C. W. Cropper, 
Wm. Perry Watson, 
G. F. Pitts, 
John Keating, 
John Lochner, 
L. J. Gordon, 
S. A. Heifer, 
I. N. Quimby, 
John Faber, 
C. F. Kyte, 
Geo. W. King, 
John P. Henry, 
W. J. Parker, 
A. V. Hill, 

No. Members, 42. 



Arlington 
Jersey City 



(( 



Hoboken 
Jersey City 



Hoboken. 

Jersey City 
«< 

(« 

Snake Hill 

Jersey City 

<< 

Guttenburg 



J. R. Everitt, 
R. Belmer, 

B. P. Craig, 
Hamilton Vreeland, 
W. S. Boyd, 

J. H. Kirk, 
J. J. Craven, 
Conrad Wienges, 
John D. McGill, 
W. W. Varick, 
N. Allen, 
M. Lampson, 
H. B. Rue, 
Joseph F. Finn, 
T. J. McLoughlin, 
R. F. Chabert, 
F. G. Payne, 
E. L. Bull, 

C. D. Hill, 

O. H. Wiegand. 

D. R. Blanchard, 



Jersey City 



Hoboken 
Jersey City 



(i 



(( 



(( 



<t 



(( 



Hoboken 
it 

Jersey City 

Hoboken 

Bergen Point 

Jersey City 
«« 



HUNTERDON COUNTY. 

(Society organized June 12, 1821.) 



A.^l.Cooi^tryPres.,Pt, Pleasant, Pa. 

O. H. Sproul, Secy^ Flemington 

Isaac S. Cramer, Treas., " 

Geo. N. Best, Rep., 

John E. Anderson, 

N. B. Boileau, 

W. E. Berkaw, 

W. S. Creveling, 

E. W. Closson, 

C. F. Creveling, 



Rosemont 

Neshanic 

Jutland 

Annandale 

Valley 

Lambertville 

Reaville 



W. E. Cornog, 

E. K. Deemy, 
J. H. Evving, 
J: H. Fretz, 
M. D. Knight, 
C. W. Larison, 

F. W Larison, 
E. D. Leidy, 
W. R. Little, 
Peter McGill, 



SeargeaHtsville 

Frenchtown 

Flemington 

Stockton 

Little York 

Ringoes 

Lambertville 

Baptisttown 

Bloomsbury 

Lambertville 



i6 



MEDICAL SOCIETY OF NEW JERSEY. 



A. B. Nash, 
Geo. T. Ribble, 
Geo. L. Romine, 
Wm. H. Schenck, 



Frenchtown Geo. R. Sullivan, 

Milford Jas. W. Snowball, 

LamberivilU A. C. Smith, 

Flemington Jos. W. Silvara, 



M. Abel, 



No. Members, 28. 



Flemington 



«( 



Bloomsbury 
Ringoes 



HONORARY MEMBERS. 

Providence, R, 1, W. D. Wolverton, U, 5. Army 



MERCER COUNTY. 



(Society organized July 24, 1848.) 



H. G. Norton, Pres., 
C. F. Adams, V, Pres., 

B. W. McGalliard, Secy, 
Wm. Elmer, Treas., 

I. M. Shepherd, Refi., 
Elmer Barwis, 
H. M. Beatty, 

C. P. Britton, 
John Bmyere, 

C. R. Burroughs, 

F. V. Cantwell, 
Wm. A. Clark, 
H. W. Coleman, 
H. B. Costill, 

A H. Dey, 
C. H. Dunham, 

G. H. Franklin, 
Ezra M. Hunt, 
Mozart Jenkins, 
E. W. Johnson, 
H.^. Johnson, 
John Kirby, 
W. S. Lalor, 
C. B. Leavitt, 



Trenton Lyman Leavitt, 
" T. H. Mackenzie, 

.W. G. McDonald, 
C. H. Mcllwaine, 
N. B. Oliphant, 
W. W. L. Phillips, 
Wm. Rice, 
E. H. Rogers, 
R. R. Rogers, Jr., 
R. R. Rogers, Sr., 
J. B. Shaw, 
Cornelius Shepherd, 
E. B. Skellinger, 
Wm. McD. Struble, 
L. D. Tompkins, 
W. B. Van Duyn, 
J. W. Ward, 
David Warman, 
H. M. Weeks, 
H. G. Wetherill, 
J. H. Wikoff, 
Lloyd Wilber, 
Wm.Wilber, 
Abner Woodward, 



i< 



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tt 



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tt 



tf 



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tf 



n 



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tt 



Hightstown 
Trenton 



Lawrenceville 
Trenton 



Trenton 



Princeton 
Hightstown 



ft 



Trenton 



No. Members, 48. 



MEDICAL SOCIETY OF NEW JERSEY. 1/ 

MIDDLESEX COUNTY. 

(Society organized June i6, 1816. Meets third Wednesday, Jan., Apr., July and Oct.) 



S.V. D. Clark, Pres., N, Brunswick 

J. Warren Rice, F. P., 

D. C. English, Treas., •' 

D. Stephens, Secy, " 

A. V. N. Baldwin, 7?^/., '♦ 

Henry R. Baldwin, ** 

F. M. Donohue, ** 

John Helm, 

Caroline H. Marsh, " 

A. L. Smith, 

Clarence M/ Slack, ** 

H. C. Symmes, Cranbury 

C. H. Voorhees, New Brunswick 

No. Members, 25. 



N. Williamson, 
C. H. Andrus, 
Edw. B. Dana, 
A. Clark Hunt, 
W. V McKenzie 
John G. Wilson, 
J. J. Bissett, 
A. Treganowan, 
F. E. Riva, 
S. M. Disbrow, 
J. L. Suydam, 
J. C. Holmes, 



New Brunswick 
Metuchen 



t( 



Perth Amboy 

Patersoft 

South Amboy 

Milltown 

Old Bridge 

Jamesburg 

Cranbury 



MONMOUTH COUNTY. 



(Society organized July 16, 1816 ) 



D. M. Forman, Sec'y, Freehold 
A. T. Applegate, Englishtown 
J. E. Arrowsmith, 
Alex. Betts, 



H. G. Cooke, 
J. E. Cooper, 
J. F. Davison, 
V. M. Disbrow, 
Edward Field, 



Keyport 

Red Bank 

Holmdel 

^Shrewsbury 

Glendola 

Farming dale 

Red Bank 



Harris P. Johnson, Allentoimt 
C. Knecht, Matawan 

Wm. R. Kinmouth, Farmingdale 
I. S. Long, Freehold 

J. G. Maynard, " 

Sarah F. Macintosh, Asbury Park 
Geo. W. MacMillan, Turkey 

Henry Mitchell, Asbury Park 



J. B. Goodenough, Long Branch 
D. D. Hendrickson, Middletown 
H.A.Hendrickson, At'cHighlands 
W. M. Hepburn, Freehold 

H. S. Houghton, Monnith Beach 
A. J Jackson, Maiawan 

Sam'l Johnson, Ocean Grove 

3 



Freehold 

Imlaystowft 

Allentoavn 

Keyport 



Harry Neafie, 

F. C. Price, 

P. B. Pumyea, 

Edgar Roberts, 

Edwin Reed, " 

Edward F. Taylor, Middletown 

Chas. H. Thompson, Belmar 

Fred. Thompson, 



((. 



i8 



MEDICAL SOCIETY OF NEW JERSEY. 



Wm. W. Trout, 
Wm. B. Warner, 

A. V. Conover, 
S. M. Disbrow, 

No. Members, 34. 



Spring Lake Geo. T. Welch, 
Red Bank Geo. F. Wilbur, 

HONORARY MEMBERS. 

Freehold Robert Laird, 
Farmtngdale 

MORRIS COUNTY. 

(Society organized June i, 1815.) 



Passaic 
Asbury Park 

Manasquan 



Cuthbert Wigg, Pres., Boonton 
James Douglass, V.P.yMorristown 
Levi Farrow, Secy, Middle Valley 
J. S. Stiger, Treas., Mendham 
E. P. Cooper, Rep,^ 
C. Anderson, 
N. H. Adsit, 

• 

P. C. Barker, 
G. A. Becker, 
A. E. Carpenter, 
L. W. Case, 
I. W. Condict, 
T. R. Crittenden, 
G. O. Cummins, 
H. V. Day, 
G. S. Degroot, 
G. H. Foster. 



F. W. Flagge, Rockaway 

H. W. Kice, Port Oram 

A. A. Lewis, Morristown 

Wm. L. Linabery, Dover-Illinois 



Troy Hills 

Madison 

Succasunna 

Morristown 

Boonton 
Montclair 

Dover 

<( 

<< 



Bloomingdale 
Mendham 
Rockaway 

HONORARY 



C. Y. Swan, 
No. Members, 33. 



A. A. Mackwithey, 
C. N. Miller, 
F. W. Owen, 
J. H. O'Riley, 
Stephen Pierson 
S. H. Reed, 
Wm. H. Risk, 
J. B. Risk, 
J. G. Ryerson, 
Henry Stiger, 
S. Utter, 
John Walters, 

MEMBER. 

Morristown 



Poinpton 

Flanders 

Morristown 



(( 



Madison 

Summit 

Morristown 

Boonton 

Mendham 

Woodport 

Port Oram 



0. W. Budlong, 

1. H. Piatt. 

0. A. Wood, 
R. L. Disbrow, 

1. W. Kirk, 

No. Members, 10. 



OCEAN COUNTY. 

Lakewood E. C. Disbrow, 

*' I. C. Schurman, 

Forked River W. H. Hall, 

Toms River W. B. Searles, 

Manchester David Mount, 



Toms River 

(( 

Lakewood 



MEDICAL SOCIETY OF NEW JERSEY. 
PASSAIC COUNTY. 

(Society organized July 14, 1844. Meetings monthly on third Tuesday.) 



19 



T. J. Kane, Pres.^ Paterson W. B. Johnson, 

W. K. Newton, V, Pres., " H. Kip, 



J. W. Williams, Sec'y, 

M. A.. Mackintosh, Treas.^ 

J. W. Atkinson, Hep.y 

E. J. Marsh, Censor, 
C. Terriberry, Censor, 
G. W. Terriberry, Censor, 

F. E. Agnew, 



J. H. Banta, 
G. H. Balleray, 
J. S. Bibby, 
W. Blundell, 
p. T. Bowden, 
J. A. Browne, 
W. H. Carroll, 
F. F. C. Demarest, 
E. W. Doty, 
Wm. Flitcroft, 
O. V. Garnett, 
M. W. Gillson, 
J. T. Gillson, 
W. S. Green, 
J. F. Hadley, 
P. A. Harris, 
J. H. Henggeler, 



J. L. Leal, 
E. S. McClellan, 
S. R. Merrill, 
J. R. Merrill, 

B. C. Magennis, 

C. F. W. Myers, 
A. J. McBride, 
E. M. Moran, 
R. Neer, 
W. Neer, 
T. F. O'Grady, 
T. L. Paton, 
H. Parke, 

Passaic J. P. Paxton, 

A. W. Rogers, 
Pater son B. H. Rogers, 
J.,M. Stewart, 
J. W. Smith, 
R. H. Terhune, 
P. H. Terhune, 
" S. Van Dalsen, 

Passaic C. S. Van Riper, 
Paterson C. Van Riper, 
H. D. Withers, 



{( 



<< 



•( 



<< 



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« 



<< 



tt 



(< 



<i 



i< 



(< 



Paterson 



It 



(< 



(< 



(« 



(« 



(< 



Passaic 



<« 



Paterson 



<( 



Passaic 
Paterson 



HONORARY MEMBER. 

J. C. Herrick, Colorado Springs, Col. 
No. Members, 52. 

SALEM COUNTY. 

(Society organized May 4, 18S0.) 

L. L. Glover, TV^j., Haddonfield W. S. Patrick, Rep., Woodstowft 

L. F. Halsey, V. Pres., Swedesboro B. A. Waddington, Censor, Salem 

Henry Chavanne, Sec'y and W. H. James, Censor, Pennsville 

Treas., Salem D. Garrison, Censor, Penns Grov 



20 



MEDICAL SOCIETY OF NEW JERSEY. 



E. E. DeGrofft. 
M. J. Paulding, 
L. A. D. Allen, 
W. Oilman, 

Prof. B. F. Shimwell, 

" H. A. Hare, 
Chas. S. Turnbull, 

No. Members, 15. 



Camden F. Balderback, 

Daretown W. T. Good, 

Woodstown E. B. Sharp, 
Q. V. Gibbon, 

HONORARY MEMBERS. 

Phtla. H. M. Christian, 

" Mordecai Price, 



Salem 

Quintan 

Roadstown 

Salem 

Phihu 



Capt. Chas. Mcllvain, Haddonfield 



SOMERSET COUNTY. 

(Society organized May, x8i6.) 

Q,,^,Y.Y\€t\^x,Pres.,Bound Brook J. F. McWilliam, 
W.B. Mathewson, V,P,,Somerville A. P; Hunt, 
J. P. Hecht, Cor, Sec'y, Raritan T. H. Flynn, 
L. T. Reed, Rec. Secy, Somerville 
W. H. Merrill, Treas,, 5. Branch 



Somerville 



i< 



B. B. Matthews, 
W. B. Ribble, 



A. L. Stillwell, Rep.y Somerville S. O. B. Taylor, 
H. G. Wagoner, " E. M. Stelle, 

Mary E. Gaston, " 

W. J. Swinton, 

No. Members, 18. 

SUSSEX COUNTY. 

(Society organized August 22, 1829.) 

B.^.FQvgusson, Pres.,Beemerville P. N. Jacobus, 

L. C. Burd, V. Pres., Ogdensburg Sidney Strailey, 

L. D. Miller, Secy, Newton E. Schumo, 

E. Morrison, Treas., '* J. Hedges, 

C. K. Davison, Rep., Stanhope J. C. Price, 



Bound Brook 

East Millstone 

Millstone 

Bernardsville 

Jos. Howard Cooper, Middlebush 

Peter J. Leglio, WarrenviLe 



Bruno Hood, 
Ed. Dalrymple, 
J. S. Wolfe, 
J. Moore, 
H. Van Gaasbeck, 
J. B. Pellet, 
J. P. Couse, 
Sheppard Voorhees, 

No. Members, 25. 



Newton Martin Cole, 
Branchville John Strader, 

Coleville J. F. McCloughan, 
Deckertown T. Andress, 
J. N. Miller, 
Hamburg J. L. Hetzel, 
Carlos Allen, 
Newton 



Newton 

Andover 

Branchville 



(t 



Hainsville 

Lafayette 

Swartswood 

Sparta 

Layton 

Stillwater 

Vernon 



MEDICAL SOCIETY OF NEW JERSEY. 
UNION COUNTY. 

( Society organized June 7, 1869.) 

M. B. Long, Pres., Plainfield J. P. R?illy, 

H. Page Hough, V.Pres., Rahway L. W. Glazebrook, 

N. L. Wilson, Secy, Elizabeth J. R. English, Jr., 

F. W. Westcott, TV., Scotch Plains T. J. Jackson, 

D. E. Decker, Rep., Woodbridge D. W. C. Hough, 

Alonzo Pettit, Elizabeth 

Thomas L. Hough, " 



21 



Elizabeth 

Irvington 

Springfield 

Rahway 



«< 



<( 



<< 



(< 



<( 



(< 



(i 



(( 



Plainfield 



J. S. Crane, 
Victor Mravlag, 
T. N. McLean, 
David Schleimer, 
Wm. A. M. Mack, 
A. Q. Donovan, 
Eleanor Gait Simmons, 
E. R. O'Reilly, 

D. M. Miller, 

E. B. Grier, 
W. F. Turner, 
Theo. F. Livingood, 
Geo. H. Bridgeman, 
James S. Green, 
S. J. Keefe, 
R. J. Montfort, 
A. Stern. 

No. Members, 47. 

WARREN COUNTY. 

- (Society organized February 15, 1836. Annual Meeting first Tuesday in June.) 

Wm. J. Burd, Pres., Belvidere James M. Reese, Phillipsburg 

L. B Hoagland, F. Pres,, Oxford William Kline, 

J. C. Johnson, Sec^y, Blairstovn Wm. C. Albertson, Belvidere 

Wm. H. McGee, 7>., Belvidere G. Wyckoff Cummins, " 

]o\{n\i. Gn^\h, Rep., Philipsburg H. O. Carhart, Blair stown 

John S. Cook, Hackettstown M. N. Armstrong, Newton 

A. C. Van Syckle, " Bonn W. Hoagland, Oxford 

P. F. Hulshizer, Stewartsville G. O. Tunison, " 

L. C. Osmun, Phillipsburg Wm. Stites, Washington 

Isaac Barber, " C. B. Smith, " 

No. Members, 20. 



W. U. Selover, 
E. B. Silvers, 
W. E. Cladek, 
J.J.Daly, 
Jno. M. Randolph 
J. B. Probasco, 
T. H. Tomlinson, 
G. W. Endicott, 

E. W. Hedges, 
A. Manning, 
W. H. Murray, 
J. H. Carman, 
William Gale, 
J. B. Harrison, 
J. A. Coles, 
Wm. K. Gray, 
J. K. McConnell, 

F. M. Corwin, 



Westfield 

Scotch Plains 

East Orange 

Cranford 

Bergen Point 



V 



SUMMARY. 



Atlantic, 


- 19 


Monmouth. 


- 34 


Bergen, 


25 


Morris, 


33 


Burlington, 


- 25 


Ocean, - 


- 10 


Camden, 


- 56 


Passaic, 


52 


Cape May, 


- 16 


Salem, - 


• 15 


Cumberland, 


24 


Somerset, - 


18 


Essex, - 


- 157 


Sussex. 


- 25 


Gloucester, 


18 


Union, 


47 


Hudson, 


- 42 


Warren, - 


- 20 


Hunterdon, 


28 






Mercer, 


- - 48 




737 


Middlesex, 


25 







TRANSACTIONS 



OV THE 



Medical Society of New Jersey. 



The One Hundred and Twenty-Seventh Annual Meeting. 



West End Hotel, Asbury Park. 



TUESDAY, JUNE 27, 1893. 

The meeting was called to order at 1 1 o'clock A. M., 
by the President, Dr. Welch. Rev. S. Edward Young, 
of Asbury Park, was introduced and offered prayer. 
The President announced the appointment of Dr. Henry 
Mitchell as a member of the Committee on Credentials. 

The Secretary read the report of the Committee on 
Credentials, as follows : 

The Committee on Credentials would report that it had examined 
the certificates of annual delegates received from the District Medical 
Societies in the state and found them to be in accordance with the 
provisions of the by-laws. No report was received from Warren. 
The roll is presented with this report. 

Certificates of nominations of Permanent Delegates from Union, 
nominating Drs. Alonzo Pettit and E. B. Silvers ; from Passaic, Phil. 
A. Harris ; from Gloucester, George E. Reading ; from Salem, B. A. 
Waddington, were received and ex.imined and found to be in accord- 
ance with the by-laws. 

Henry Mitchell, 

Archibald Mercer, 
William Pierson, 

Committee. 
On motion, the report was accepted. 



24 MEDICAL SOCIETY OF NEW JERSEY. 

The roll, as presented by this Committee, was then 
called : 

Atlantic — Board man Reed * T. H. Boy sen,* J. A. Joy. Mem- 
bers, 18. 

Bergen— D. A. Currie, G. H. McFadden,* J. A. Wells,* D. St. 
John, S. E. Armstrong. Members, 25. 

Burlington — A. H. Small, B. W. Macfarland, E. Hollingshead , 
D. G. Van Mater, W. P. Melcher.* Members. 25. 

Camden — W. H. Ireland, H. H. Sherk, Joel Fithian, Wm. H. 
Iszard, Wm. Kensinger, D. W. Benjamin. Members, 56. 

Cape J/^/— Eugene Way,* B. T. Abbot,* J. C. Marshall,* I. M. 
Downs.* Members, 16. 

Cumberland— Qhaj&, H. Dare, Orange H. Adams, J. R. Dare, W. L. 
Newell,*, J, C. Applegate. Members, 24. 

Essex — Wm. Rankin. Jos. D. Osborne, L. E. Hollister, E. W. 
Edwards,* J. W. Stickler, T. R. Chambers, Thos. D. English, H. L. 
Coit, Jos. Few Smith, E. N. Lyon, A. Mercer, Geo. R. Kent, C. D. 
Bennett, Ed. J. Ill, W. B. Graves,* T. N. Gray,* C. W. Hagen.* 
Members, 157. 

Gloucester — George C. Laws, Eugene Oliphant,* H. A. Wilson,* 
James Hunter.* Members, 18. 

Hudson — B. Edge, M. Lampson, C. Wienges, S. A. Heifer, H. B. 
Rue,* I. Nevin,* J. J. Broderick. Members, 42. 

Hunterdon — Peter McGill, E. W. Closson, E. D. Leidy, Isaac S. 
Cramer, A. M. Cooper, A. C. Smith. Members, 28. 

Mercer — Elmer Barwis,* W. A. Clark, H. G. Wetherill, T. H. 
Mackenzie,* N. B. Oliphant,* W. McD. Struble,* Wm. Wilber.* Mem- 
bers, 48. 

Middlesex— '^. V. D. Clark,* A. V. N. Baldwin, E. B. Dana, C. H. 
Voorhees,* S. M. Disbrow. Members, 25. 

Monmouth — J. E. Cooper, V. M. Disbrow, Ed. Field,* C. Knecht,* 
I. S. Long, F. C. Price.* Members, 36. 

Morris — F. W. Owen, Jas. Douglas, C. Wigg, John Walters, G. O. 
Cummings, I. W. Condict. Members, 33. 

Ocean — I. H. Piatt, I C. Schureman,* E. L. Disbrow.* Members, 
10. 

Passaic — ^J. L. Leal, T. F. O'Grady, M. A. Mackintosh, T. J. Kane, 
C. Terriberr>',* H. Parke,* J. W. Williams.* Members, 52. 



MINUTES. 25 

SaUm^W. H. James, W. T. Good,* E. B. Sharp,* F. Bilderback,* 
D. Garrison. Members, 16 

Somerset — Mary E. Gaston, John H. Cooper,* L. T. Reed, J. P. 
Hecht.* Members, 18. 

Sussex — H. Van Gaasbeck,* J. B. Pellet,* J. P. Couse,* John 
Moore,* Sidney Strailey. Members, 25. 

Union— ^, L. Wilson,* W. E. Cladek,* J. S. Green.* T. N. McLean,* 
W. U. Selover, J. B. Harrison, W. K. Gray. Members, 47. 

PERMANENT DELEGATES. 

H. C. Neer, James M. Ridge,* Alex. Marcy, V. M. D. Marcy,* W. 
H. C. Smith, C. F. J. Lehlbach, Charles Young, John J. H. Love, 
Arthur Ward, Joseph C. Young, Isaac S. Cramer, D. D McGill, 
J. Howard Pugh, R. F. Chabert. Cornelius Shepard, Charles H. 
Dunham,* C. H. Andruss, Henry Mitchell, Henry C. Cooke, I. W. 
Condict, John Stiger, W. B. Johnson, H. G. Wagnor, Sidney Strailey, 
J. H. Griffith. 

FELLOWS. 

S. H. Pennington, Ezra M. Hunt,* John C. Johnson,* Franklin 

Gauntt, H. R. Baldwin,* John S. Cook,* Alex. W. Rogers, P. C. 

Barker*, Charles J. Kipp, John W. Ward, H. Genet Taylor, E. J. 

Marsh.* 

REPORTERS. 

Atlantic, H. C. James; Bergen, S. E. Armstrong; Burlington, W. 
H. Shipps* ; Camden, D. Strock ; Cumberland, Matt. K. Elmer* ; 
Essex, Theo. W. Corwin ; Gloucester, S. F. Ashcraft ; Hudson, J. A. 
Exton ; Mercer, C. F. Adams ; Middlesex, A. V. N. Baldwin ; Mon- 
mouth, F. C. Price* ; Morris, E. P. Cooper ; Ocean, I. W. Kirk ; 
Passaic, J. W. Atkinson* ; Salem, W. S. Patrick* ; Somerset, A. L. 
Stillwell*; Sussex, L. C. Burd*; Union, H. P. Hough*; Warren, 
J. H. Griffith. 

OFFICERS. 

President— Gto. T. Welch. 

First Vice-President — John G. Ryerson. 

Second *' — O. H. SprouL* 

Third " — William Elmer, Jr. 

Corresponding Secretary — E. L. B. Godfrey. 

Recording Secretary — William Pierson. 

Treasurer — Archibald Mercer. 

Standing Committee — D. C. English, E. P. Townsend,* H. W. 
Elmer. 

* Absent. 



26 MEDICAL SOCIETY OF NEW JERSEY. 

Delegates from corresponding societies: New York — 
Walter B. Chase, M. D. Pennsylvafiia — John W. Groflf, 
M. D. 

The report of Committee of Arrangements was then 
read by its Chairman, Dr. S. Johnson : 

Mr. President and Gentlemen of the New Jersey Medical Society : 

As Chairman of the Committee of Arrangements, it is fitting that I 
should state why, on this occasion, you are convened at Asbury Park, 
and not at Spring Lake, as had been expected. But one hotel at 
Spring Lake is of sufficient capacity to accommodate the meeting of 
this Society, viz. : the Monmouth House, and after consultation and 
persuasion, the proprietor could not be induced to open his hotel The 
Sea Girt Hotel was next considered, it being in proximity to Spring 
Lake, but upon inspection was deemed unsuitable. In our dilemma we 
turned to Asbury Park, and after visiting and consulting with your 
President, at Passaic, and Secretary at Orange, it was thought advis- 
able to select this city. 

The Committee has done all in its power towards providing satis- 
factory accommodations and hopes that its efforts may prove success- 
ful. It has not been considered necessary, nor perhaps best, to 
arrange for a banquet, as we believe the members will be amply 
supplied with all the essentials by the genial proprietor of the West 
End. You are met to deliberate upon and advance the interests of 
medical science, and in so doing it is hoped you may have a continual 
feast. 

Four years have passed since we last had the pleasure of extending 
to you our hospitality. Meanwhile, we have grown rapidly and per- 
manently, and we feel that it is merited. Our situation is unsurpassed 
in all elements necessary for the success and popularity of a Itealth 
resort. Our life-giving ocean breezes know no pollution, and temper 
the summer's oppressiveness. We are in a little section of the 
Jersey shore, extending from Long Branch to Bradley Beach, which is 
about the only spot where there is almost absolute freedom from that 
characteristic Jersey pest — the mosquito. The sanitary conditions are 
the best and we invite inspection of our health statistics. The at- 
tractions, both numerous and accessible, afford ample facilities for the 
most restful recreation. Bathing, fishing, boating, driving and bicy- 
cling offer the best inducements to their devotees. 



MINUTES. 27 

Among the elder Greeks and Persians, complete surrender was 
betoken to the vassals of a conqueror by offering them water and 
earth. To-day we tender you the ocean, and if you want the earth, 
you can have it ! We believe that next to the kingdom of the 
Nazarene, for benignity to mankind, stands the regular and faithful 
practice of medicine among the people of the world ; that efficiency in 
this holy art can be attained only by scrupulous and constant confer- 
ence of those engaged therein, coupled with individual diligence ; that 
the quack who writes, " Every man his own doctor," should write 
again and name his book, "Every man his own undertaker"; and we 
believe that since the days when Homer crj'stalized in deathless song 
the brilliant feats of ^sculapius, until this present hour, there has not 
been, nor is, a goodlier company of ^sculapius' disciples than that 
which is our host to-day. 

Science can never rest ; ec^ch century opens new realms, each decade 
brings new conflicts, each year has special problems. If medical 
science in the thirteenth, fourteenth and fifteenth centuries W£ts sum- 
moned to combat diseases, or phases of diseases, before unknown, 
this/>ne hundred and twenty-seventh annual meeting of the Medical 
Society of New Jersey must discuss at least special complications and 
particular perils. Grip and cholera, contagions, measures for sanita- 
tion, discovering and destroying germs, etc., in all their variety and 
vastness, are before us for consideration. 

It is said that when John Hancock. President of the Continnental 
Congress, signed his name to the Declaration of Independence, in 
1776, that he wrote his signature in characters so large and so loud, 
that the cry for liberty, which they represented, was heard around the 
world. 

It may be said with equal truth and propriety, that when such men 
as Gross, Agnew, Sands and hundreds of minor lights, fall sud- 
denly into the arms of death, the shock is felt wherever there is 
suffering humanity or surgery is practiced. 

These men, by their brilliant genius, patient industry, wonderful 
skill and dexterity, saved the lives of many and made the burden of 
life less irksome ^o countless numbers of this and future generations. 
Who shall say the former is more deserving of fame than the latter? 

Poets sing that he who dries a tear or saves a pang to suffering 
humanity has rendered a service more praiseworthy than to have 
fought a battle or captured a ship. 



28 MEDICAL SOCIETY OF NEW JERSEY. 

Those who have advocated great principles or instilled pure and 
noble thoughts into the minds of the people; those who have con- 
quered the enemy of the state ; he who, by his conquests, has added 
to the territorial possessions of his sovereign ; statesmen, who have 
originated and by their zeal and ability carried through the Congress 
or the Parliament, measures for the relief of the oppressed — all these 
have received just praises and adulation during their life, and monu- 
ments have been erected to perpetuate their memories after they were 
dead. Equally, if not more, are they benefactors of their race who 
devise means for saving life, instead of destroying it. who. by their 
genius, rid the world of a scourge or a plague, as well as they who 
destroy an army or take a city. 

The hope of the Committee of Arrangements is that your every 
faculty may be at its best; that the charms of this beautiful city may 
enchant you sufficiently to insure your coming to us soon again, and 
that your convening here may bring some balm to bruised and 
grieved humanity. 

The Medical Society of this county fully appreciates the honor of 
having this venerable body to entertain so frequently, and we sincerely 
trust that historic Monmouth may treat you worthy of frequent 
visitations in the future. 

We welcome you most heartily to this resort, and trust that after 
your sojourn with us you will leave Asbury Park with renewed 
strength and vigor, such as thousands of yearly visitors find upon our 
shores. 

The rest here obtained, coupled with the benefit accruing from the 
interchange of ideas, we believe will give you fresh strength for 
future conquests in advancing the standards of medical science 
towards nobler achievements. 

The report, on motion, was accepted, and referred to 
Committee on Publication. 

An abstract of the minutes of last annual meeting was 
read, and, on motion of Dr. Mercer, the minutes, as 
published in the Transactions, were adopted. 

William Perry Watson : We recognize in our 
midst, the Hon. James A. Bradley, founder of Asbury 
Park. I move that he be invited to a seat on the plat- 
form. 



MINUTES. 29 

Dr. English moved to amend, by adding also the name 
of Rev. S. Edward Young. The motion, with the 
amendment, was adopted. 

Mr. James A. Bradley, on accepting the invitation, 
said: 

You must not think that because I am taking my coat off I am 
going to weary you with a long speech. I am not. But I wish to 
thank you for the honor you have done our town in coming here 
again, and in expressing my thanks I express those of the council 
and of the people here. I think it is an honor to any town for a body 
such as this to hold its conventions in their midst. 

During the summer as you can see by the number of bath-houses 
along the ocean, we have thousands of people here — our regular 
guests and often large excursions, and I have been annoyed for some 
years because I did not have a proper room in case of accidents — 
say where persons become exhausted in the water or in any other 
way. But I am now building a room which will be set apart entirely 
for emergencies of this kind, and in which there will be such appli- 
ances as may he deemed necessary. It occurred to me to-day that I 
would like to commemorate your visit by having the picture of this 
body put upon the wall of that room, and I am going to ask whether 
you will not honor our town and honor me by standing for your 
picture on the hotel piazza; and if you will be good enough to accept 
it, I wish to present to each one of you a copy of the picture. 

Dr. Pierson moved the acceptance of the generous 
offer of Mr. Bradley. Carried unanimously. 

On motion, Samuel Johnson, Henry Mitchell and 
George F. Wilbur were appointed a committee to arrange 
for having the picture taken. 

The report of the Committee on Business was read by 
Dr. Selover, and on motion, was adopted. 

To the New Jersey State Medical Society : 

Gentlemen — The Chairman of the Committee on Business greatly 
regrets that circumstances beyond his control prevents his attendance 
at your meeting. He begs leave respectfully to submit his report as 
follows : 



30 MEDICAL SOCIETY OF NEW JERSEY. 

The printed program is submitted as correct. The Committee has 
also arranged that Dr. H. G. Wetherill, of Trenton, should read a 
paper upon " Salpingitis and Pelvic Adhesions." Should no oppor- 
tunity occur earlier in the session, this paper may be presented under 
the appropriate order on Wednesday morning. The subject suggested 
for discussion at your next annual meeting is "Angina Pectoris, its 
true pathology and an explanation of its sudden termination in 
death." 

Henry R. Baldwin, Chairman, 
W. Updyke Selover, 
Walter B. Johnson. 

A. Pettit and W. P. Watson were appointed to 
take the leading part in the discussion. 

The election of Permanent Delegates then took place. 
The names presented being those of Alonzo Pettit 
and E. B. Silvers, of Union county; P. A. Harris, of 
Passaic; G. E. Reading, of Gloucester, and B. A. 
Waddington, of Salem. The President appointed 
D. C. English and Henry Mitchell, tellers, and after the 
balloting, all five of the gentlemen named were declared 
duly elected. 

Dr. Ill offered the following: 

memorandum. 

The question whether the State Medical Society shall continue its 
present financial policy of accumulating a fund from year to year, 
involves the secondar)'^ question of continuing to assess its members, 
that is, the members of the District Medical Societies, beyond the 
necessities of covering its annual running expenses. For, with the 
exception of the interest drawn from the invested funds already 
accumulated, and an occasional fee for the granting of a degree, the 
only source of income, both for the purpose of defraying the running 
annual expenses and future accumulations, must come from the yearly 
assessments levied upon the members of the several District Societies. 

There is no doubt that the Constitution and the By-Laws of the 
State Society give it full power to assess the District Societies, pro 



Minutes. 31 

rata of membership, for any purpose within its legitimate sphere, even 
to accumulate a fund for such purposes within the limit prescribed by 
the Charter. 

In paragraph 3 of the Charter, we read : ** And be it enacted, that 
this Society shall have power to * * * assess from time to time, 
an annuity upon the District or County Societies in the ratio of their 
membership respectively * * * and may hold any estate, real 
^nd personal, the annual income of which shall not exceed one 
thousand dollars." 

As the State Society is a delegated body, being, according to the 
6th article of the Charter, "composed of delegates chosen by and 
from each of the District or County Societies which now are, or 
which under the authority of the said Society may be hereafter insti- 
tuted," it follows that no assessments whatever, whether for the simple 
defrayment of running expenses or for the purpose of accumulation 
can be made, except by order and consent of those who are assessed ; 
no taxation without representation. 

There is nothing here, nor can any rule be found established by any 
subsequent action of the Society, which provides for a special amount 
of assessment to be set aside for an accumulating fund, to the 
amount of the constitutional limit of one thousand dollars annual 
income, which would represent a capital of from $20,000 to $25,000. 

It seems, indeed, that this plan of accumulating a permanent fund 
has crept and grown into usage by the efforts of some of the officers 
of the Society to provide the means gradually to pay for the publica- 
tion of the Transactions in future, without submitting the members 
of the District Societies to assessment. This is fully explained by 
reference to the remarks made at the last annual nteeting, by Dr. 
Baldwin (see Transactions 1892, page 64). 

While there is no doubt that the motives which favored this ten- 
dency to accumulate a permanent fund were well meant and entirely 
unselfish, it is undoubtedly also true that a large number of the mem- 
bers of the profession represented in the State Society, if not a 
majority, take a somewhat broader view of what should be its finan- 
cial policy. They do not believe that the chief object of its organiza- 
tion is to publish ** Transactions," and to secure the means for their 
future publication, in all coming time, by the accumulation of a large 
fund. This refusal to continue unnecessary assessments, while a 
large fund has been already accumulated, is based upon sound sense 



32 MEDICAL SOCIETY OF NEW JERSEY. 

and equity. The medical profession of New Jersey, in this genera- 
ation. is not in a condition which should induce it. either as a matter 
of sound policy or of a mistaken sentimental liberality, to tax itself 
beyond paying for its own needs, in order to relieve and exempt the 
next and coming generation from all taxation. And this is what the 
persistence in the accumulating system will inevitably lead to. 

Do we fear or expect that the next generation of medical men of 
New Jersey will become so reduced in their financial capacity, or in 
the ardor and liberality for the advancement of their professional ends, 
that they will refuse to pay their own way as they go — that they will 
deny themselves the privilege and pleasure of putting their own 
hands in their own pockets in order to pay for the publication of their 
own Transactions? To assume the possibility of such financial and 
professional degeneration in the coming body of medical men of New 
Jersey, would be an insulting testimonium paupertatis, which we have 
no right to give in advance. And that the Society is not yet in line 
with the accumulation scheme, has been evidenced by the fact that, 
at its last meeting, it refused to order an assessment of the District 
Societies, but ordered the expenses to be paid from the accumulated 
fund. 

The time has come then to call a halt to this system of unnecessary 
taxation ; and the only question remains, whether there is any way to 
justly re-imburse the members of the District Societies, directly, for 
the over-payment levied upon them by this illy-conceived system of 
over-taxation, or, if no such equitable plan can be formulated, to 
resort to the only other course apparently left — that of suspending all 
annual assessments, until the present fund is exhausted. Which 
shall it be ? -This is the situation which confronts the Society to-day. 

In the opinion of many members of this Society, and in the 
opinion of a large majority of the members of a number of District 
Societies, there seems to be a way of rectifying, at least to some 
extent, the unjust system of the past, in an equitable manner, while at 
the same time accomplishing good to the profession at large, and 
cementing it more closely in the works of fraternity and benefi- 
cence. This way would be to expend a considerable portion of the 
accumulated fund to aid and to enlarge the scope and usefulness of 
the Society for the Relief of Widows and Orphans of Medical Men 
of New Jersey. 

This should not be done through the mode of making a general 



MINUTES. 33 

appropriation of a specified sum for the benefit of the latter Society, 
a procedure which would be liable to the objection that it appropri- 
ated money outside the jurisdiction of the members of the State 
Society, and beyond its control ; but it should be done in such a 
manner as to distribute the benefits of such appropriation, at once, 
equally among the members of the State and District Medical 
Societies, one and all, and would act as a source of mutual strength 
to the State Society, the District Societies and the Society for the 
Relief of Widows and Orphans of Medical Men. 

It is not necessar}' to go into further argumentation or detail. 
The whole subject may be condensed in the following preamble and 
resolutions, which it is proposed shall be offered to the State Society, 
at its coming meeting : 

Whereas, This Society does not consider it good financial policy to 
continue in, or to return to, the past system of accumulating a per- 
manent fund, as it constitutes an inequitable over-taxation to the present 
generation and an unwarranted want of confidence in the financial 
capacity or willingness, to bear an equitable share of their professional 
burdens of those who come after us ; and as the over-payment levied 
upon the members of the District Societies should either be returned to 
them, or the fund thus accumulated, be placed in the way of gradual 
extinction by the suspension of all assessments until it shall have 
been exhausted; and as the former method seems to be the most 
equitable and just, and as the Society for the Relief of Widows and 
Orphans of Medical Men of New Jersey furnishes a means for a per- 
fectly equitable distribution of the accumulated fund among the 
members of the State and District Societies, to whom it justly 
belongs ; therefore be it 

Resolved, That the Treasurer of the Medical Society of New 
Jersey, in conjunction with the President and Secretary, be and are 
hereby authorized to pay whatever sum shall be necessary to cover 
the initiation fee and first assessment, whatever the amount may be, 
to constitute each member of the several District Societies also a 
member of the Society for the Relief of Widows and Orphans of 
Medical Men of New Jersey. 

Resolved, That the Secretary of the State Society shall, as soon as 
practicable, obtain from the Secretaries of the several District Societies, 
a complete and accurate list of their members, to be handed over by 
him to the Secretary of the Society for the Relief of Widows and 
Orphans of Medical Men of New Jersey, and that on due election of 
such members and notification^ thereof to the President, Secretary and 
Treasurer of the State Society, the sum necessary to cover the initiation 
fee and first assessment of such members elected, shall be paid over 
by the Treasurer of the State Society to the Treasurer of the Society 
for the Relief of Widows and Orphans of Medical Men of New 
Jersey. 

Resolved, That the Treasurer of the Medical Society of New Jersey 
shall be authorized, in conjunction with the President and Secretary, 



34 MEDICAL SOCIETY OF NEW JERSEY. 

to pay whatever sum necessary to cover the initiation fee and one 
assessment for such members of the several District Societies who 
may already be members of the Society for the Relief of Widows and 
Orphans of Medical Men of New Jersey, and that on verification of 
such membership of both societies, and the payment by the Treas- 
urer of the State Society of the sum stated, such members shall 
be credited with the amount on their assessments. 

Dr. Ill wished the consideration of, and action upon 
the resolution might take place at the afternoon session at 
the time when the Committee should report on the Gross 
Monument Fund. He said he ofifered it with no other 
motive except a purely philanthropic one. 

D. C. English raised the point of order that under 
a resolution passed at the last annual meeting, action 
upon any motion which involved the expenditure of 
funds except for current expenses of the Society should 
be delayed one year. 

E. L. B. Godfrey moved that the matter be 
referred to the Standing Committee which should report 
upon it at the next annual meeting. 

Dr. Lehlbach thought the motion should be enter- 
tained at once. The Society should not bind itself hand 
anci foot to the Standing Committee. He did not think 
the resolution just read by the Secretary, offered last year 
by Dr. Baldwin, and adopted by the Society, referred to 
future meetings. 

Dr. Sheppard said he had seconded Dr. Baldwin's 
resolution last year, relating to the question of appro- 
priation of funds, because he was heartily in sympathy 
with it and was to-day. Its object was to prevent at any 
time the appropriation of funds except for the legitimate 
purpose for which they had been raised, namely, the 
needs of the Society, unless there had been at least a 
year*s notice. 

D. C. English moved, as an amendment to Dr. 
Godfrey's motion, that the resolutions be ordered printed 



MINUTES. 35 

in the minutes and that discussion upon them be postponed 
until the next annual meeting. 

The amendment was adopted and Dr. Ill's resolutions 
were ordered printed in the minutes, to lie over one year. 
(See above). 

In presenting the report of the Committee on Ethics 
and Judicial Business, D. C. English said that no 
case had been presented for action during the year. 

Archibald Mercer read his report as Treasurer, and 
on motion the report was received and referred to the 
Auditing Committee. (See Appendix). 

Dr. Mercer presented the following bills, and on 
motion they were ordered paid : 

Wm. Pierson $i 5.00 

Orange Chronicle 12.00 

E. L. B. Godfrey 16.06 

A. M. Condit *. 1 2 00 

Standing Committee 8.55 

E. L. B. Godfrey, Corresponding Secretary, read 
his report, and on motion it was received and referred to 
the Committee on Publication. (See Appendix). 

The report of the Committee on Honorary Member- 
ship and Honorary Degree of Doctor of Medicine was 
read by its Chairman, H. G. Taylor. Dr. Taylor 
said no names had been submitted to the Committee for 
action. At the last Annual Meeting, however, a report 
had been made recommending for honorary membership, 
Drs. F. S. Dennis, John H. Ripley and Virgil P. Gibney, 
of New York, and under the By-Laws these names were 
to be balloted upon at the present meeting. 

William Pierson moved that the Society proceed 
to the election of honorary members. The motion was 
carried. 



36 MEDICAL SOCIETY OF NEW JERSEY. 

The Society proceeded to ballot, the President ap- 
pointing as tellers, Drs. W. B. Johnson and H. G. Taylor. 

Dr. F. S. Dennis, Dr. John H. Ripley and Dr. V. P. 
•Gibney, having received the required number of votes, 
were declared duly elected honorary members. 

The Society adjourned until 3 P. M. 

FIRST DAY— AFTERNOON SESSION. 

The Society was called to order by the President, at 
3.30 P. M. 

The report of the Standing Committee was read by 
its Chairman, D. C. English. On motion, the report 
was received and referred to the Committee on Pub- 
lication. 

Dr.- Benjamin would call attention to the great change 
which had taken place in therapeutics as indicated in the 
report, for it would be observed ttiat no remedies had 
been recommended from the different counties excepting 
patent medicines. He did not mean medicines with 
copyrighted labels, but medicines which had actually 
been patented, like antipyrin. This was the more re- 
markable since the number of patented drugs was small 
compared with the copyrighted and others. Even our 
old standard, calomel, had been recommended by only 
one man, but he, it seemed, had tried to make up for all 
the rest. He was reminded of the incident where a 
doctor went to have his pocket-case filled and the drug- 
gist asked him what he should put into it. He replied 
to put in some opium, some quinine and some calomel. 
Being asked what else, he said he did not need anything 
more. 

Dr. Benjamin also remarked that the treatment of 
typhoid fever had improved very much or the character 
of the disease had become milder. His attention had 



MINUTES. 37 

been arrested particularly by the report from the Cooper 
Hospital at Camden, where during the past two years 
the mortality from typhoid fever had been reduced to 
two per cent. One of the fatal cases was in a man who 
undoubtedly would have g^ot well had he not disobeyed 
orders and got out of bed when known to have a weak 
heart. He died suddenly of heart failure. When look- 
ing up the mortality rate from typhoid fever, he found 
that in one hospital in Philadelphia it was six per cent., 
and the treatment employed, said to be the best, was by 
the cold pack. In the Cooper Hospital they had not 
used the cold pack, but had employed the antiseptic 
treatment of disinfecting the bowels. In the Pennsyl- 
vania Hospital the death-rate from typhoid was nine per 
cent. — lower than it had been. He had found to his 
great astonishment that the Philadelphia Homoeopathic 
Hospital reported a death-rate from this disease of 
twenty-four per cent. The location of their hospital was 
one of the best, and he was unable to understand why 
they should have a death-rate of twelve hundred per 
cent, higher than others— five hundred per cent, higher 
than the most unfavorable statistics in Philadelphia 
under the old school system ; yet the homoeopathists laid 
special claim to superiority in fevers, if in anything. The 
epidemics had been the same, the circumstances the 
same in the two cases. No explanation had been offered, 
notwithstanding the daily press had mentioned the 
subject. 

He thought any decrease in the number of cases of 
typhoid fever must be attributed to improved water 
supply, as had long been taught in this Society. 

Regarding the treatment of pneumonia. Dr. Benjamin 
could warmly endorse a method which had been elo- 
quently advocated by a member of the Society, namely, 



38 MEDICAL SOCIETY OF NEW JERSEY. 

the use of veratrum viride, especially in the early stage, 
until the pulse had been brought down from 140, or 120, 
or whatever high rate it might have attained, to or below 
the normal, where it should be kept. He believed the 
death-rate could be reduced by this means to at least 
five per cent. 

Dr. Lehlbach wished to know whether the Committee 
recommended a change of the By-Laws relating to the 
nature of the report of the Standing Committee. 

Dr. English replied that the report had only contained 
the suggestion that the Committee be allowed to exercise 
its judgment, but no resolution had been offered. 

William Perry Watson, of Jersey City, called the 
attention of the members to two classes of cases which 
he had observed in the hospital, one with the classical 
symptoms of typhoid fever, the other closely simulating 
this disease, especially during the first week or ten days. 
He had seen many of the latter class in the St. Francis 
Hospital and in private practice during the past three 
years. During the first week the temperature was 
usually about 103^ F. In children there might be coma 
at the beginning, lasting twenty-four or forty-eight hours. 
Recovery was apt to take place in a week or ten days. 
In addition to the temperature, there was headache, 
sometimes delirium, looseness of the bowels. He had 
been at a loss to give these cases a name until recently 
he had read an article by Dr. Byers, of South Carolina, 
in which he called them gastro-intestinal fever, non- 
malarial. These patients did well on antiseptic treat- 
ment and a diet not of milk. He had heretofore called 
them aborted typhoid, and was convinced they were not 
cases of true typhoid. They should be excluded in 
making up statistics of mortality, etc., of typhoid fever. 

Dr. Wetherell thought the suggestion made in the 



MINUTES. 39 

report should be acted upon and the Standing Committee 
be relieved of the necessity of compiling a report of 
the health of the State each year, a work which was in 
large measure regularly done by the State Board of 
Health. 

Henry Mitchell also thought that, owing to the 
demands of the- By-Laws, the work of the Standing 
Committee had never been expended in the proper 
direction. The Committee did an immense^ amount of 
excellent work, but it was of a kind in which the mem- 
bers had lost all interest before it reached them in the 
Transactions. The Committee should not, of course, be 
held responsible for the kind of material which they had 
to put into their report. He thought that portion of the 
report relating to cholera should be printed in pamphlet 
form for distribution. 

Dr. English made a few closing remarks. He thanked 
Dr. Benjamin for the thoughts he had presented. In 
mentioning the medicines which had been recommended, 
the Committee had desired to thus call the attention of 
the profession to the fact that such preparations were 
being largely used and the information might be of value 
in connection with the topic to be discussed to-morrow 
morning, — " Is the philosophical practice of medicine not 
materially jeopardized by the modern methods of venders 
of drugs?" 

E. L. B. Godfrey, in line with the suggestion made 
by Dr. Mitchell, moved that the portion of the report of 
the Standing Committee relating to cholera be published 
in pamphlet form and be distributed to the members of 
the profession throughout the State and to the press. 
Carried. 

The report of the Committee on the Gross Monument 
Fund, was presented by D. A. Currie. W. B. 



40 MEDICAL SOCIETY OF NEW JERSEY. 

Johnson moved that the report be accepted and the 
Committee continued. Carried. 

J. W. Stickler read a paper, "Bovine Tuberculosis; 
Its Transmission to Man and How to Prevent It." 

It was discussed by'Drs. Benjamin, Miller, Corlies, 
Baldwin, Rogers, Laws, Charles Young, Coit and the 
author. 

Dr. Benjamin asked a question : The report stated that 
three children who had drank milk of a tuberculous cow 
had died in the course of the year. Were they of the 
same family or of diflferent families? 

Dr. Stickler: They were of the same family. 

W. B. E. Miller, of Camden, present by invitation, 
said he heartily endorsed all that had been stated in the 
paper, particularly the letter of Dr. Billings' relating to the 
method of exterminating and controlling the disease. 
There probably would continue to be some persons who 
would doubt the relationship between bovine and human 
tuberculosis, but to his mind there was not a shadow of 
doubt as to transmission or inoculability. So many 
cases had been brought to his attention the past five 
years as to fully convince him that tuberculosis could be 
acquired by man from cattle, by the use of both milk 
and meat. There could be no question, either, as to 
tuberculosis in cattle being on the increase in this country, 
especially in the eastern states. But out of thousands 
of inspections of cattle from the west he had found very 
few cases of tuberculosis. It existed chiefly among milk- 
cows which had been kept at rest, perhaps bred near the 
great eastern cities ; and the cow most likely to be affected, 
in his experience, was the Jersey, her conformation and 
breeding seemed to favor tuberculosis more than that of 
other cattle in this country. Jersey cows of mixed breed 
were affected less. The most dangerous of all meat was 



MINUTES. 41 

that of the worn-out dairy cow. Having served her use- 
fulness as a milker, she was sold or given away, and was 
put upon the market by the unscrupulous butcher. In 
his opinion the law should prohibit the . sale of the 
" bologna beef cow," unless under the control of com- 
petent medical men and veterinarians. 

Dr. Miller thought the time had arrived when the 
state legislatures should enact laws requiring the inspec- 
tion of all dairy herds for the existence of tuberculosis. 
The medical profession ought to educate the public to 
understand the necessity for this. There were means, 
particularly the use of tuberculin, for making a pretty 
correct diagnosis of tubercular disease in cows, and he 
would not permit milk to be used even from those sus- 
pected of tuberculosis. He would differ from one author 
quoted in the paper, and would not permit the milk from 
a tuberculous cow to be fed even to swine, for it had been 
demonstrated very positively that the hog could be 
infected by milk. This had been recently shown by 
experiments at the University of Pennsylvania. If sus- 
pected animals were put in quarantine and it should be 
proven they were not really tubercular, the state should 
compensate the owner; if affected, the owner should 
bear the entire loss. They had tried very hard during 
the last winter to have a law passed in Pennsylvania, but 
the opposition from milk dealers and others had yet been 
too strong. Veterinarians and physicians should work 
together in having necessary laws enacted. 

Dr. Corlies, by invitation, said he was afraid his views 
might clash with some of those held by the author. He 
had hoped Dr. Stickler would talk some of his bacillus 
theory of tuberculosis, but that had scarcely been alluded 
to in the paper. The belief had been expressed by some 
that bovine tuberculosis was on the increase, and that 



42 MEDICAL SOCIETY OF NEW JERSEY. 

existed to an alarming extent. Dr. Corlies had visited 
many of the largest herds in the country and he believed 
the disease was rather on the decline. The Jersey cow 
brought the disease with her, or developed it soon after 
arriving in this country, which would account for its ex- 
istence in that breed. He was inclined to think climatic 
changes had much to do with producing tuberculosis, 
and that the bacillus was probably an after-expression. 
Careful investigation had shown that about forty per cent, 
of the^e imported cows died of tuberculosis, — a very 
large mortality rate. The disease sought animals with 
delicate meat. The reason why he thought it was ofl the 
decline was the fact that four or five years ago it was 
common, on visiting a herd of four or five hundred, to 
take out four or five cattle with tuberculosis, whereas at 
present he seldom found one. In one herd particularly, 
of four or five hundred, there had been but one case of 
tuberculosis in two years, and that was in an imported 
cow. It was a question whether the milk was a very 
radical means of contagion. It had been claimed that 
the tubercle bacillus entered the system with the milk 
and infected the lungs, etc., but Prof. Formad, of Phila- 
delphia, had examined milk from five cows known to be 
tuberculous and which they afterward killed because of 
the existence of that disease, yet he found no tubercle 
bacilli or anything which was likely to produce tubercu- 
losis. Those same five cows had five calves running on 
them from one v/eek to four months and not one of the 
calves ever took the disease. That, he thought, showed 
pretty conclusively that tuberculosis was not very vio- 
lently infectious through the milk. At Rhinebeck, in 
New York, there was a herd from which two cases of 
tuberculosis were taken a year ago and he visited the 
herd again two months since and there were no new 



MINUTES. 43 

cases. Those two cows had calves running with them 
when he saw them, and the calves had shown no evidence 
of the disease, although now over a year old. 

Dr. Baldwin thought the medical profession was pretty 
well agreed at the present time that the cause of tuber- 
culosis was the bacillus tuberculosis ; that the failure to 
develop the disease in all cases of exposure was due to 
the fact that the ground was not favorable. The infection 
was not communicated through the air, but solely 
through the expectoration, discharges and infected diet. 
He thought it had also been proven that general tuber- 
culosis occurred from infection of the general circulation 
by the altered or degenerated tubercular nodule. A cow 
might have tuberculosis without the milk containing 
tubercle bacilli, in which case the calf might escape 
infection. In human beings, autopsy often showed old 
tubercular nodules which had laid dormant. In this way 
one might explain the freedom from infection in the 
cases cited by the last speaker. Much had been ^ said 
about man being infected with tuberculosis from cattle. 
Might not the reverse also take place? Might not the 
sputa deposited by tubercular people upon the ground 
and grass infect cattle ? 

Dr. Rogers thought the fact that an animal, the off- 
spring of tuberculous parents, escaping the disease for 
some months or years might be explained on the basis 
that a certain age, according to the hereditary predis- 
position of the individual, had often to be attained before 
the affection manifested itself. 

Dr. Laws had been told by a man who had tuberculosis, 
that chickens eating his sputa had contracted and died of 
the disease. He queried whether the flesh of the 
chickens and their eggs might not communicate the 
disease to man. He had seen a curious car-load of cattle 



44 MEDICAL SOCIETY OF NEW JERSEY. 

one nighty and was told that they were bologna cattle 
going to a Jersey town to be slaughtered. Was the saus- 
age into which they were made sufficiently disinfected 
by the process to destroy the tubercular germs? He 
had seen two or three families destroyed by the trans- 
mission of tuberculosis. 

Dr. Coit thought the subject one of the most 
important to which the attention of the medical profes- 
sion had been directed in many years. There were two 
or more conclusions at which he had arrived from a study 
of it. First, as to the danger. Dr. Brush, than whom 
there was no higher authority, had said that the human 
race was a veritable parasite among the cows. We ate 
her flesh, we drank her milk, we clothed our feet with her 
hide, we made fertilizers of her bones, we combed our 
hair with her horns, we drank her blood. There could be 
very little question, then, of the danger of acquiring her 
diseases. The fact that the normal temperature of the 
cow was 103^ F.. made her a better soil for the develop- 
ment of the tubercle bacillus. Dr. Coit had been in 
consultation with Prof. Prudden lately, with reference to 
the possibility of dissemination of tuberculosis through 
the milk. Prof. Prudden had found it very difficult to 
make bacteriological examination a safeguard in the 
matter of milk. He had seen tubercle bacilli in milk but 
once ; that was in a specimen from a cow known to have 
tuberculosis. It seemed to Dr. Coit that the line of 
protection was by concerted action between the medical 
profession and veterinarians. He had been told by Prof. 
Liautard, of New York, that if the Essex County Medical 
Society had sought the aid of veterinarians in securing a 
better milk supply, it was the first time the medical 
profession in this country had recognized the value of 
consulting with veterinarians in carrying on their work. 



MINUTES. 45 

It would seem, then, that up to this time there had been 
no alliance between these two branches of the profession, 
and the error should be corrected at once. 

Dr. Stickler made a few closing remarks. It was 
extremely desirable to get the authorities to take some 
action which would make it impossible, if in human 
power, to prevent our wives, children, brothers and sisters 
from contracting and dying of tuberculosis. There was 
very good reason for the continuance of the disease so 
long as we made use of the milk and meat of infected 
cattle. He felt very strongly on the point and hoped 
the Society would act in the matter. * 

Dr. C. A. Young said he had just been told that 
while there had been legislation in New Jersey for stamp- 
ing out contagious pneumonia in cattle, nothing had 
been done about bovine tuberculosis. 

Dr. Young offered the following motion, which was 
adopted: 

Whereas, This Society is deeply impressed with the necessity of 
sanitary measures to counteract the evil resulting from the existence 
and communicability of bovine tuberculosis, and to the end that it may 
be limited and eradicated, be it 

Resolved^ That a committee of three be appointed from the mem- 
bership hereof, to confer with the State Board of Health, the State 
Sanitary Association and the Veterinary Associations of the State, 
with the power to influence, as far as may be proper, legislative action 
in the matter. 

Later, the President appointed the following named 
gentlemen on the committee: J. W. Stickler, Chair- 
man ; A. V. N. Baldwin, and Chas. A. Young. 

Dr. Pierson moved that the thanks of the Society be 
tendered Drs. Miller and Corlies, veterinary surgeons, for 
their presence at this meeting and for taking part in the 
discussion during the afternoon. Carried. 



46 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Henry Mitchell said he was able, through the 
courtesy of Mr. James A. Bradley, to present each mem- 
ber with tickets for use on the electric railway. 

Dr. Elmer moved that the thanks of the Society be 
tendered Mr. Bradley for the courtesy. Carried. 

Dr. Wetherill presented a man who had been operated 
upon by Dr. Solis Cohen, of Philadelphia, removing the 
entire larvnx with the vocal cords, and who had since 
acquired the power to speak in a whisper. It was the 
only case of the kind on record. The man wore a 
tracheotomy tube low down. 

The President announced the following committees : 

Committee on Treasurer' s Accounts. — D. B. St. John, C. J. Kipp 
and W. B. Johnson. 

Committee on Nominations. — D. A. Currie, Chairman; D. Mc 
Farland, W. H. Ireland, C. H. Dare, J. D. Osborne, Geo. E. Reading, 
M. Lampson, E. D. Leidy, H. G. Wetherill, A. V. N. Baldwin, J. E. 
Cooper, J. S. Stiger, I. H. Piatt, T. F. O'Gra^y, D. Garrison, H. G. 
Wagoner, Sidney Strailey, W. U. Selover, J. H. Griffith. 

FIRST DAY — EVENING SESSION. 

The meeting was called to order at 8.15 o'clock, by the 
First Vice-President, John G. Ryerson. 

The President, George T. Welch, of Passaic, read 
his annual address, " Therapeutical Superstition." 

On motion. Dr. Welch was tendered a vote of thanks 
for his very excellent address, and a copy was requested 
for publication in the Transactions. 

W. B. Johnson, of Paterson, read a paper, " Legis- 
lation for the Prevention of Blindness.** 

On motion, a vote of thanks was tendered Dr. Johnson 
for his able paper, and a copy was requested for publica- 
tion in the Transactions. 

P. A. Harris moved that a committee of three be 



MINUTES. 47 

appointed to consider the question of legislation for the 
prevention of blindness, to report at the next annual 
meeting of the Society. The motion was adopted and 
the President appointed on the committee, W. B. 
Johnson, C. J. Kipp and P. A. Harris. 

The Society adjourned until 9 A. M., Wednesday, 
June 28. 

WEDNESDAY, JUNE 28. 

TJie Society was called to order at 9.20 A. M., by the 
President. 

The report of delegates to and reception of delegates 
from Corresponding Societies being in order. Dr. W. B. 
Chase, of Brooklyn, delegate from the Medical Society 
of the State of New York, made some remarks, express- 
ing great pleasure at being at the meeting of a Society 
whose history and age placed it second to none among 
the states. Since coming here he appreciated even more 
than he had before that the Medical Society of the State 
of New York and that of New Jersey had very much 
in common. He congratulated both states on having 
taken into their own hands the question of the qualifica- 
tion to practice medicine. He had been greatly 
interested in the paper on ** Legislation for the Prevention 
of Blindness,** and in the honor which it had justly 
ascribed to the late Dr. Cornelius R. Agnew for taking 
the initiatory in this matter, and he hoped that, like m 
the State of New York, the legislature of New Jersey 
could be induced to take some action in the matter. In 
conclusion, he said it would give the Medical Society of 
the State of New York great pleasure to reciprocate the 
courtesy which had been shown him as their delegate. 

Dr. J. W. Goffe made some remarks, bringing congratu- 



\ 



48 MEDICAL SOCIETY OF NEW JERSEY. 

lations from the Medical Society of Pennsylvania, and 
expressing thanks for the cordiality with which he had 
been received as its delegate. 

Dr. Welch : It gives the New Jersey Medical Society 
great pleasure to have the gentlemen here this morning 
and to reciprocate the sentiments which they have 
expressed. We shall be very glad to have them with us 
again, and at all times to welcome delegates from our 
sister societies. 

W. B. Johnson reported as delegate by proxy to 
the American Medical Association at Milwaukee. In the 
course of his remarks he said there was action taken by 
the American Medical Association, calling the attention 
of the State Societies, and through the State Societies, 
that of the District Medical Societies, to the question of 
the revision of the code of ethics. A resolution was 
passed which he thought should be considered and acted 
Upon, not only by the State Society, but also by the 
District Societies, and arrangements should be made by 
which the delegates representing the New Jersey Medical 
Society at the next meeting of the American Medical 
Association, should be able to go there with a full know- 
ledge of the views of the State Society and of the 
medical gentlemen throughout the state. The resolution 
to which he referred read as follows : " Resolved, by the 
American Medical Association, that the respective State 
Medical Societies entitled to representation in this Asso- 
ciation, and through them their affiliated local societies, 
are hereby requested to consider the revision of the code 
of ethics and report to the Association at the next 
annual meeting." 

It was moved that the report be received and that its 
recommendations be acted upon. Carried. 

Dr. Redding reported as delegate to the Medical 



MINUTES. 49 

Society of Pennsylvania, where he said he had been 
received with the greatest courtesy and cordiality. 

The discussion upon the subject presented at the last 
annual meeting — ** Is the philosophical practice of medi- 
cine not materially jeapordized by the modern methods 
of venders of drugs ?" — was opened by Dr. H. L. Coit, as 
follows : 

" The proper limitations of this subject should be 
considered at the outset, in order that the discussion may 
be definite and clear. That the philosophical practice of 
medicine is jeopardized by these persons may be inferred 
from the following facts: First, the purpose of these 
drug venders is almost wholly commercial. Second, The 
materials which they dispense consist, for the most part, 
of substances which, while practically valueless to the 
profession, are unfortunately not without some reputation. 
Therefore, the modern methods of venders of drugs 
cannot sustain any real or proper relation to the philo- 
sophical practice of medicine. 

** There is no department of medicine that has received 
so much thoughtful study, and, at the same time, been* 
subjected to so much misdirected effort as therapeutics. 
Consequently, there are in vogue to-day a vast 
medley of rational and irrational methods of treating 
disease. We are convinced that there is no part 
of medical work which more urgently demands atten- 
tion at the hands of physicians, in order to stay the 
progress of influences which are at work to divert scien- 
tific medicine from its proper channels. 

** The term philosophical, in its connection with medi- 
cation, deserves careful consideration. Upon a clear 
conception of its significance, depends an intelligent 
grasp of our subject. Philosophical medication consists 
of therapeutic procedures, induced from data, furnished 



50 MEDICAL SOCIETY OF NEW JERSEY. 

first, by the natural history of the condition to be treated ; 
and, second, by the natural history of the agent or agents 
employed. Such a course of action must of necessity be 
positive, because it is dictated by a logical course of 
reasoning. It will always be found in conflict with 
empyrical methods and with the sophistical deductions of 
those, whose conclusions are the result of false reason- 
ing. It will not admit of the prohibitory feature which 
excludes from the materia medica all agents not 
catalogued by an exclusive or sectarian system. Its 
distinguishing characteristic is liberty, that which follows 
demonstration. If a scientific reason can be given for 
any therapeutic measure, and this has been arrived at by 
the inductive (the only scientific) method of reasoning, 
the same may justly claim to be philosopical. 

" The development of rational therapeutics has been 
three-sided, and has been the result of researches in three 
widely different fields of observation. Three classes of 
workers have pursued the study from three separate 
starting points, and have labored with earnest zeal until 
their paths were found to converge and unite. We refer 
to the Physiologist, the Pathologist and the Pharmacist. 
The physician who is thoroughly equipped and who can 
justly lay claim to the use of the scientific method in the 
treatment of disease, must represent and embody in him- 
self the findings of each of these classes of special 
workers. He must at least possess a knowledge of the 
physiological effects of the agents employed, of the patho- 
logical indications for treatment, and also have a wide 
acquaintance with the materia medica and its chemistry. 
With the present limitations of our knowledge, it must be 
admitted that only a part of our therapeutic measures 
are based upon the triple foundation which we have 
indicated ; but this state of things is rapidly giving place 



MINUTES. 51 

to an era of reason and precision. Through the labors 
of such men as Dalton, Wood and Squibb the empyricism 
which dominated the professional mind in the past is 
becoming obsolete, and instead, we recognize the growing 
influence of the three important factors in the scientific 
method. 

"The Physiological factor in therapy is. the first arid, 
probably, the most important part of this triple alliance. 
Physiology bears the same relation to rational thera- 
peutics that anatomy does to surgical diagnosis. It has 
to do with the experimental observations in the animal, 
the natural history of human health and a correct 
knowledge of the action of remedial agents in modify- 
ing healthy states and functions. Very great advances 
have been made in the rational treatment of disease by 
investigations bearing directly upon the vegetative func- 
tions of nutrition, respiration, excretion and secretion. 
Physiological chemistry has taught us how to meet many 
of the abnormal conditions of these processes. So, also 
with the more distinctly animal functions of the nervous 
the muscular and circulatory systems. The observations 
upon lower animals with drug effects, under varying con- 
ditions, have added to our armamentarium many instru- 
ments of precision. The chemical and microscopical 
study of the fluids of the body, the blood and the 
several secretions have so far enlightened us, that to-day 
it is often a comparatively easy matter to maintain the 
normal balance between their constituents. 

" The Pathological factor in therapy is one, the im- 
portance of which calls for general recognition, since it is 
an essential prerequisite to the scientific treatment of 
disease. It has to do with clinical and post-mortem obser- 
vations. With every advance in pathology there should 
be a corresponding advance in rational therapeutics. 



52 MEDICAL SOCIETY OF ^EW JERSEY. 

Pathology, consisting of the natural history of diseased 
states, embraces : The cause, the course, and the conse- 
quences of abnormal conditions. The logical deductions 
from the data furnished by the causes of disease are 
often clear and conclusive, as in the therapeutic indica- 
tions suggested by miasma, the parasitic affections and 
the effects of bacterial poisons. The course of disease 
also suggests many valuable and rational aids, notwith- 
standing that this knowledge often furnishes strong 
indications for withholding interference. The conse- 
quences of disease, taken with a knowledge of physiolo- 
gical chemistry, opens up> to us a wide field for thera- 
peutic findings, which are apparent to those who have 
been obliged to combat exhaustion, hyperpyrexia, cardiac 
hypertrophy and the manifestations of voso-motor 
paralysis. The trusty agents, such as alcohol, caffein, 
the coal-tar derivatives, digitalis and strychina, by which 
we often hold the power of disease in our grasp, are all 
instruments of precision in the hand of the pathological 
therapeutist. 

** The Pharmaceutical factor in therapy is also a part 
of this base, upon which rests the superstructure of 
therapeutic truth. It has to do with the chemical 
and physical characters of remedies, and seeks to 
establish their trustworthiness. This knowledge is 
indispensable, and the time is not far distant, if fiot 
already at hand, when a physician will be seriously 
handicapped, who has not a working acquaintance with 
pharmacognosy and pharmaceutical chemistry. The 
ancient apothecary was chiefly occupied with his con- 
coctions and decoctions of impossible remedies. These 
were prepared as ignorantly as they were used by the 
empyrics of those days. Their methods illustrated by 
the confectio democritus, with its three hundred constitu 



MINUTES. 53 

ents, antedate all other factors in the development of 
therapeutic history, and pharmacy remained a wizard-like 
art until physiology and pathology called for more 
efficient aid. Modern pharmacy is the proper handmaid 
of medicine and its development into what has become 
a scientific specialty, is largely due to the demand made 
by the progress of workers in fields already mentioned. 

" The result to therapeutics, of these studies, has been 
to place it among the more exact departments of medi- 
cine. That this knowledge is available is recognized by 
all. That such a triple study is necessary to an intelli- 
gent therapeutic procedure is apparent. Thus equipped, 
the physician will never become a sectarian, nor be a 
polyprescriber ; nor, on the other hand, will he renounce 
the materia medica and profess to be a therapeutic 
nihilist. He is proof against the probings of the venders 
of proprietary compounds and will not be attracted by 
the glitter of words that portray impossible virtues, but 
exercises a discriminating judgment in the selection of 
his remedies. 

"There are three classes of tradesmen in drugs: The 
professional pharmacist, the charlatan, and the pseudo- 
scientific drug-vender. The scientific class has the first 
claim upon our attention. It embraces the manufacturing 
and dispensing pharmacist of the higher order, and 
excludes all dealers in medicines who are actuated by 
motives which are mercenary or purely commercial. 
For these, we have nothing but the highest commenda- 
tion. Their work is invaluable and the practice of 
medicine is not jeopardized by their methods. These 
are they who make our pharmacopoeias and dispensa- 
tories. We owe it to them that we have the alkaloids, 
the chemically pure salts, the assayed preparations, the 
bewildering host of synthetical compounds and the 



54 MEDICAL SOCIETY OF NEW JERSEY. 

reliable pharmacopoeal preparations. They possess the 
skill requisite in compounding our prescriptions, and so 
necessary for the scrutiny of new remedies that are 
brought to our attention. It is a significant fact, and a 
well-deserved recognition of valued service, that phar- 
macy has been elevated to its proper professional stand- 
ing, in that it has been given a place in the American 
Medical Association. 

"The charlatan represents a class of venders who, 
while they do an immense amount of harm, do not con- 
stitute the most powerful hindrance to the practice of 
medicine. His methods are so plainly quackish and his 
wares are so loudly and lavishly praised, that the thought- 
ful and cautious are not misled. The only point of 
connection between the charlatan and physician is in the 
havoc wrought in the persons of those who have been 
drugged and poisoned. The nostrum vender is purely 
commercial and always dishonest. He is properly charac- 
terized as an advertising liar and false labeler, and legal 
enactments should compel him to disgorge his ill-gotten 
gains. The secular press, and the weak religious press, are 
the messengers of his falsehoods and lend an air of respect- 
ibility to an unmistakable fraud. These papers furnish 
wonderful accounts of spontaneous cures, Saratoga 
miracles, gold extracting gold cures, indian bitters, 
electric pads, and, as though this were not enough, we 
find a world-renowned electrician lending himself to the 
sale of electricity by the bottleful, and a misguided public 
seeking for the secrets of health* in a bottle of so-called 
** tonic,** when, lo, it is lager beer. These facts are a 
disgrace, and a blot upon the fair name of our national 
intelligence. 

** The pseudo-scientific vender is unquestionably our 
greatest enemy. He is the thorn in the flesh of the 



/ 



MINUTES. 55 

practitioner. His true nature is often concealed by a show 
of apparent truth. His reasoning, however, is weak, and 
his conclusions, though much believed by himself, are not 
logical and, therefore unreliable. His motives are com- 
mercial and mercenary although his advertising schemes 
are professedly only for the profession. He employs 
chemists to write him certificates, and superanuated 
doctors to edit his voluminous literature. The virtues of 
his products are largely imaginary and have no proper 
experimental or clinical observations to jusify their claims. 
There is no limit to the credulity of the human mind, 
and, with an imagination on the alert, there are no bounds 

 

to therapeutic faith. Therapeutic activity may be deduced 
from every known substance in the several kingdoms of 
the earth ; and votaries may be found who ascribe to 
them some potential power in disease. 

** To particularize on the useless materials foisted upon 
us would be a waste of time. The shelves of our phar- 
macies are loaded down with them and the shopkeeper 
is often made bankrupt in trying to supply the fickle 
demand created by the ubiquitous sample bottle. 

" It is reasonable to conclude that the philosophical 
practice of medicine is materially jeopardized : 

** /« so far as venders of drugs depart from the truth, 
and fail to be actuated by the scientific spirit in their work, 

" There can be no question that the larger number of 
the statements made through the journals and in the 
circulars concerning medicines of unknown composition, 
are either exaggerated or altogether false. The statistics 
which are appended are often fictitious, and even when 
they bear the semblance of truth the data is unreliable, 
because the conclusions are drawn frorn an insufficient 
number of cases or, perhaps, obtained by incompetent 
observers. The following is an example of these false 



$6 MEDICAL SOCIETY OF NEW JERSEY. 

statements and could be duplicated many score of times 
if necessary : ' A vegetable alterative and tonic *; com- 
position only hinted at, and found in the advertising pages 
of a leading medical journal. * Causes the elimination of 
specific blood poison, the repair of wasted and disorgan- 
ized tissues and the restoration of the vital forces to their 
normal activity. In the treatment of syphilis it super- 
sedes the use of both mercury and iodide of potassium, 
and is a reliable remedy for the evil effects produced by 
the excessive use of these drugs. It is also specially 
indicated in all scrofulous affections and is invaluable in 
the treatment of eczema and other skin diseases, in 
chronic rheumatism, old chronic ulcers, etc.* We fail 
to distinguish between the evils growing out of the 
patent medicine plague and those resulting from this 
means of medication. Nor is the departure from truth 
to be wholly laid at the door of the vender, for the 
physicians who lend themselves to these advertising 
schemes and write over their names about * filling the bill,' 
* happy results,* * marked success,* * a veritable boon,' and 
all concerning the imaginary effects on an isolated case 
of prostatic enlargement, well know that their state- 
ments are fabrications and absolutely valueless. 

*'The true scientific spirit is foreign to all this class of 
work, and this is apparent in the unwillingness of the 
manufacturer to reveal the nature of the composition, 
or, if this is referred to at all, it is by naming the 
materials without the methods of combination or the 
the quantity of each. It is passing strange, that reput- 
able physicians will endorse this trade-like spirit. A 
recent pamphlet, containing no scientific information, 
furnished one hundred and eighty-three physicians' testi- 
monials to a preparation, the name of which was coined 
by the vender, and the composition of which was referred 



MINUTES. 57 

to ii> two obscure lines on the inside of the cover. A 
distinguishing feature of this class of literature is the 
attention paid to the indications for the use of the pre- 
paration. Formula, not clear; indications, numerous; 
dose, liberal. Cardiac depressants are thus administered 
indiscriminately. A preparation of antifebrin in pill 
form of unknown quantity and composition, advertised 
in a reputable medical weekly, with distinguished 
medical endorsement artd said to be useful in ten differ- 
ent maladies, is actually compounded and put upon the 
market by a wholesale grocer. When physicians with a 
national reputation, professors in medical colleges, and 
high officers of a medical congress, will descend to these 
unseemly practices, where shallVe look for wisdom ? 

*' It is a sad commentary on the intelligence of the 
medical profession that so many of its members are 
swayed by unscientific methods and allow a class of 
venders, not only to suggest their course of action, but 
also the agents to be employed. The habit so easily 
acquired of using these ready-made preparations, is 
damaging to the professional mind, and each time the 
physician yields he drifts nearer and nearer to the ranks 
of the empyric. 

"* Use becometh a habit in a man.* The law of accu- 
mulation is operative in the descending scale, and it is not 
difficult to see that by frequently resorting to these time- 
saving combinations we must fall away from the more 
difficult practice of finding a reason for the therapeutic 
faith that is within us. The physician who maintains 
his scientific integrity against the inroads of the drug- 
vender, not only works with precision, but, event- 
ually, will contribute his quota to the development of 
rational therapeutics.** 

Dr. Rogers had been pleased to learn from the British 



58 MEDICAL SOCIETY OF NEW JERSEY. 

Medical Journal that there they have a chemist to whom 
they submit for examination those combinations of drugs 
or cures offered by the pharmacists to the medical profes- 
sion. It was possible for three or four articles to be 
combined in a scientific way so as to be valuable as a 
remedy if we could place reliance upon its preparation. 
We had in this country some drug firms, such as the 
Wyeths, of Philadelphia, which put up given preparations 
in a manner more reliable than what could be obtained 
by writing a prescription to be compounded by the local 
druggist. Doubtless there were a good many prepara- 
tions which would be found valuable if submitted to 
chemical test and shown to be what the manufacturer 
claimed they were. There was, however, a great deal of 
poly-pharmacy which was utterly wrong, and physicians 
ought not to prescribe remedies, the composition of 
which was unknown to them. There were few instances 
where more than two or three drugs could be combined 
with advantage. 

Dr. Reading thought that all scientific men could 
not fail to heartily endorse all that had been stated 
in the paper. In line with what had been referred 
to yesterday, he thought we should bear in mind, the 
distinction between patented and copyrighted medicines. 
To the latter belonged the proprietary preparations, 
and for many of these we could have only words of 
condemnation. But there were certain chemical sub- 
stances discovered and patented by one who was not a 
member of the medical profession, who did not offer an 
absurd combination, but a new remedy ; and, as scientific 
men, it was our duty to use the agent if it were valuable 
in therapeutics. Some of these new remedies we know 
could not be replaced by other remedies. 

Alexander Marcy being called upon, said he did 



MINUTES. 59 

not feel prepared to discuss the subject. There were 
some remedies put up by certain drug firms which he had 
never been able to obtain in satisfactory form by writing 
a prescription. He had about made up his mind that the 
best way was to leave the matter with the individual 
physicians, and he believed the majority of the 
members of this Society could be trusted to exercise 
sufficient discrimination not to bring disgrace upon 
themselves. 

Dr. Andrus, of Middlesex said there were certain 
remedies bearing the name of some man who was not a 
physician, yet the preparation was valuable in certain 
cases because it had been a prescription actually written 
and employed by some physician before the vender copy- 
righted it in his own name. While it might not be 
proper for the profession to patronize these things or to 
mention them in print, yet their value in some cases could 
not be denied. 

The third Vice-President, William Elmer, Jr., then 
read an essay on ** Quarantine of Cholera.** 

C. J. Kipp moved that the suggestion contained in 
the paper be accepted as the sentiment of the Society, 
and a copy of it be transmitted to our senators and 
members of the house of representatives. Carried. 

It was voted that the paper be published in the 
Transactions. 

S. E. Armstrong read a paper, **Some Thoughts on 
Symptoms and Diagnosis." 

On motion, it was referred to the Committee on Publi- 
cation. 

H. G. WetherilKs paper on '* Pelvic Adhesions,** 
was read by title by request of author, and referred to 
the Committee on Publication. 

Dr. Wetherill read the history of a case of supra- 



6o MEDICAL SOCIETY OF NEW JERSEY. 

vaginal hysterectomy for fibroids, and presented the 
specimen. It was referred to the Committee on Publica- 
tion. 

The report of the Committee on the Treasurer's Account 
was presented by C. J. Kipp. The accounts had been 
found correct. The Committee thought it advisable 
that some one be appointed to examine the registered 
bonds. The Committee also recommended that the 
annual assessment be one dollar for each member of the 
District Societies. 

On motion, the report was received and the recommend- 
ations adopted, and the Committee was continued to 
carry out the suggestion to examine the registered bonds. 

Action upon the amendments to the By-Laws, proposed 
at the last annual meeting, was then taken up. The first 
related to Chapter III, Section 2: — add after **the person 
chosen," except the Treasurer shall hold his office during 
the term of five years. 

Dr. Kipp explained that the object of this amendment 
was to avoid the inconvenience of the Treasurer renew- 
ing his bonds annually as the By-Laws at present required. 

Dr. Elmer, Jr., did not think the advantage was suffi- 
ciently great to justify the change. He would prefer to 
see the officers of the Society remain under its immediate 
control. 

Dr. Benjamin did not approve of the change, while 
W. B. Johnson spoke in its favor and said that when 
we got a good Treasurer we should keep him, and a term 
of office for five years was not too long when it was 
necessary to be at considerable trouble to renew bonds. 

On taking a standing vote, the proposed amendment 
was declared to have been lost, the necessary three-fourths 
vote in the affirmative not having been obtained. 

Second proposed amendment. Section 4, Chapter I: 



MINUTES. 6l 

add after the words "by individual ballot," by a three- 
fourths vote of all members present, (no election being 
possible without the presence of Qne-fifth of the total 
membership). 

On inquiry being made, the President explained that 
" one-fifth of the total membership ** referred to the meet- 
ings of the District Societies, not of the State Society. 

D. C. English moved to substitute the word ** one- 
third *' for ** one-fifth." He called attention to the fact 
that last year seven District Societies reported a member- 
ship of less than twenty and in these cases two or three 
members could elect a permanent delegate. The motion 
being seconded, was put and declared carried. 

Then the original amendment as thus amended, was 
adopted unanimously. 

The report of the Committee on " Fellow's Prize Essay," 
in the absence of Dr. E. J. Marsh, Chairman, was pre- 
sented by Dr. Kipp, who said no essay had been presented 
in competition during the year. As it had been suggested 
that probably few members knew of the existence of the 
prize, it was thought that it might be advisable to have 
it announced in the Transactions. 

W. B. Johnson moved that the report be received, 
the suggestion adopted, and the Secretary be requested 
to insert the conditions of the ** Fellow's Prize Essay " in 
the Transactions. Carried. 

The Committee on Nominations would report as 
follows : 

The Committee organized by electing D. A. Currie, Chairman, 
and George E. Reading, Secretary. 
The following nominations were made: 

President — John G. Ryerson. 
ist Vice-President — O. H. Sproul. 
2d " — Wm. Elmer, Jr. 

3d " — T. J. Smith. 



62 MEDICAL SOCIETY OF NEW JERSEY. 

Corresponding Secretary — E. L. B. Godfrey. 

Recording Secretary — Wm. Pierson. 

Treasurer ^ArchibaXd Mercer. 

Standing Committee-^D. C. English, H. W. Elmer, Wm. H. Iszard. 

Delegates to American Medical Association — ^J. Lehl, I. H. Piatt, 

* 

Alex. McAlister, C. H. Dare, George E. Reading. 

Delegates to Connecticut State Society — L. M. Halsey, I. Newton. 

Delegates to New Jersey Pharmaceutical Association — H. L. Coit, 
Chas. F. Adams, S. E. Armstrong. 

Delegates to Rhode Island State Society — E. B. Silvers, E. W. 

Clawson. 

f 
Delegate to Maryland State Society — E. L. B. Godfrey. 

Delegates to Pennsylvania State Society — J. T. Kane, E. D. Leidy, 
H. G. Buckingham, B. A. Waddington, Geo. E. Reading. 
Delegates to Massachusetts State Society — T, F. O'Grady, P. Harris. 
Delegates to New York State Association — D. C. English, E. B. 
Silvers, P. C. Barker, D. A. Currie, A. Mackintosh. 

Committee of Arrangements — S. Pierson, J. H. Griffith, S. B. 
Strailey, T. W. Oliver, T. R. Chambers. 
Place of Meeting — Lake Hopatcong. 

Time of Meeting — Tuesday and Wednesday, June 26 and 27, 1894. 
It is also recommended that the Committee on Arrangements be 
authorized to change the place of meeting if no satisfactory arrange- 
ments can be made at Lake Hopatcong. 

Respectfully submitted, 
Attest : Daniel A. Currie, 

George E. Reading, Chairman, 

Secretary^ 

Dr. Ryerson made some remarks favorable to Lake 
Hopatcong as the place of meeting, and in explanation 
of the failure to obtain accomodations there on a former 
occasion. The hotel accomodations were now ample and 
the season began there earlier. 

As there was but one candidate for each office, the 
Secretary was instructed to cast the ballot for the Society 
for all the candidates except delegates to other societies. 
The Secretary cast an affirmative ballot and declared the 



MINUTES. 



63 



following named gentlemen elected to office : President, 
John G. Ryerson, Boonton; First Vice-President, O. H. 
Sproul, Flemington ; Second Vice-President, William 
Elmer, Jr., Trenton; Third Vice-President, T. J. Smith, 
Bridgeton ; Corresponding Secretary, E. L. B. Godfrey, 
Camden; Recording Secretary, Wm. Pierson, Ocange; 
Treasurer, Archibald Mercer, Newark. Standing Com- 
mittee, D. C. English, New Brunswick ; H. W. Elmer, 
Bridgeton, and William H. Iszard, Camden. 

On motion, the gentlemen named as delegates to other 
societies were appointed. 

The recommendations of the Committee were all 
adopted. 

On motion, the President was given power to appoint 
delegates to other societies. 

The President appointed the following delegates and 
their alternates to the Pan-American Medical Congress, 
to be held in Washington, in September, 1893 : 



DELEGATES. 

Boardman Reed, Atlantic City, 
David St. John, Hackensack, 
E. L. B. Godfrey, Camden, 
T. J. Smith, Bridgeton, 
Edgar Holden, Newark, 
William Pierson, Orange, 
Jos. W. Stickler, Orange, 
Wm. P. Watson, Jersey City, 
H. G. Norton, Trenton, 
John W. Ward, Trenton, 
D. C. English, New Brunswick, 
H. G. Cooke, Holmdel, 
P. C. Barker, Morristown, 
P. A. Harris, Passaic, 
W. U. Selover, Rahway, 
John C. Johnson, Blairstown, 
B. W. McFarland, Bordentown, 
Henry Mitchell, Asbury Park, 



ALTERNATES. 

E. p. Williams, Atlantic City. 
Daniel A. Currie, Englevvood. 
Daniel Strock, Camden. 

H. W. Elmer, Bridgeton. 

Edward J. Ill, Newark. 

Chas. F. J. Lehlbach, Newark. 

Wm. J. Chandler, South Orange. 

S. A. Heifer, Hoboken. 

B. W. McGalliard, Trenton. 

W. McD. Struble, Trenton. 

A. V. N. Baldwin, N. Brunswick. 

W. B. Warner, Red Bank. 

I. W. Condict, Dover. 

F. F. C. Demarest, Passaic. 
Alonzo Pettit, Elizabeth. 
John H. Griffith, Philippsburg. 

Samuel Johnson, Asbury Park. 



64 MEDICAL SOCIETY OF NEW JERSEY. 

The President appointed as essayist for next year, 
George F. Wilbur, of Asbury Park. 

D. C. English : The gentleman who read the report 
of the Nominating Committee informed the Society 
that the nomination of Third Vice-President had been 
tendered our honored Secretary, who modestly declined. 
I desire on this occasion to mention the fact that Dr. 
Wm. Pierson has served this Society as Secretary for 
twenty-seven consecutive years, and has not, during that 
time, been absent from an annual meeting. It is a 
remarkable record, and in view of his declining the Third 
Vice-Presidency, I move that he be assured that this 
Society appreciates his long continued and faithful 
services as Recording Secretary. 

The motion was adopted unanimously. 

William Pierson : I feel quite embarrassed by 
your kind words of appreciation. I may say that I have 
not done anything more than my duty. It always gives 
me great pleasure to serve the Society. I thank you 
heartily for the aid you have rendered me in the discharge 
of my duties these many years, and you may ever 
consider my humble services at your command. 

C. J. Kipp : I move that William Pierson be made an 
honorary member of the Society. 

The President : It has been moved and seconded 
that Dr. Pierson be made honorary member. Under the 
By-Laws, action upon the motion will have to be deferred 
until the next annual meeting. 

On motion of Dr. Pierson, delegates to Corresponding 
Societies were given power to appoint their own alternates. 

P. A. Harris moved that the President isippoint a 
committee of five, of which he should, himself, be 
Chairman, to carry out the suggestion contained in the 
resolution passed by the American Medical Association, 



MINUTES. 65 

read by W. B. Johnson, in his report as delegate to 
that Association. Carried. 

The President subsequently announced the following as 
the Committee : Geo. T. Welch, P. A. Harris, W. U. 
Selover, Henry Mitchell, D. Benjamin. 

On motion, Drs. Taylor, Kipp and Rogers were con- 
tinued members of the Committee on Honorary Member- 
ship and Honorary Degree of Doctor of Medicine. 

Dr. D. C. English gave notice of an amendment to the 
By-Laws as follows : 

Notice is hereby given that an amendment will be offered for 
consideration and action at the next annual meeting, revising Section 
7, Chapter II, pertaining to the duties of the Standing Committee. 

Also offered the following : 

Resolved, That the members of this Society throughout the State 
be, and they are hereby urged, to communicate to the Reporters of 
their respective District Societies, their judgment as to the changes 
desirable in Section 7, Chapter II, of the By-Laws, and that 
the Reporters communicate such information to the Standing Com- 
mittee next year. Carried. 

Dr. Benjamin made some remarks introductory to a 
resolution which he offered later, calling attention to 
the fact that at the last session of the State legislature, 
a bill was passed at the instigation of the homoeopathists, 
practically debarring the regular profession from certain 
state hospitals. It was only by accident that know^ledge 
was obtained of the bill in time to call the governor's 
attention to the fact before he should sign it, that it 
involved in the highest degree possible the kind of class 
legislation which the homoeopathists had urged as an 
argument against a certain bill presented on a former 
occasion. In order to avoid in the future, the passage 

6 



66 MEDICAL SOCIETY OF NEW JERSEY. 

of bills prejudicial to the regular profession without its 
knowledge and opposition, Dr. Benjamin presented the 
following : 

That a committee, consisting of a member from each County 
Society, be appointed, to be known as the Committee on Legislation, 
"whose duty it shall be to examine into all legislation affecting the 
interests of this Society. 

Dr. Kipp thought that a committee so composed 
would be unwieldy, and moved, as an amendment, that 
a committee be appointed consisting of three members 
residing in Trenton, whose duty it should be to protect 
the interests of the medical profession before the State 
legislature. 

After some discussion by Drs. Godfrey, Hon. Thomas 
D. English and Harris, as to the propriety of including 
in the motion provisions for meeting the expenses of the 
committee, the motion of Dr. Kipp, which was accepted 
by Dr. Benjamin as a substitute for his original motion, 
was adopted. 

The President appointed on the Committee, Drs. Ward, 
Sheppard and Elmer. 

Henry Mitchell gave notice of the following pro- 
posed amendment to the By-Laws : 

Section lo, Chapter II, of By-Laws, the following words: " None 
of the funds of this Society shall be used for any purpose except for 
the payment of its regular annual expenses, unless the proposal for 
such expenditure shall have been submitted in writing at a previous 
annual meeting, and shall receive a three-fourths vote of all members 
present. 

It was voted that the Standing Committee be the 
Publishing Committee, with the usual powers. 

Dr. Godfrey moved that the Publishing Committee be 
requested to have the Transactions for this year bound 
in cloth. 



MINUTES. 67 

Replying to a question, Dr. English said the expense 
would be about one hundred and thirty dollars for the 
eight hundred and fifty copies. The motion was adopted. 

The Society then adjourned to meet at Lake Hopat- 
cong, the fourth Tuesday in June, 1894. 

WILLIAM PIERSON, 

Recording Secretary. 
R. C. SCHULTZ, 

Stenographer, 



APPENDIX TO THE MINUTES. 



[APPENDIX No. I.] 



Report of the Corresponding Secretary. 

Camden, N. J., June 27th, 1893. 

To the Medical Society of New Jersey: 

The Corresponding Secretary would respectfully report that he has 
attended to the duties incumbent upon him. The Transactions for 
1892 have been forwarded to the Honorary Members of the Society; 
to all the State Societies; to the New Jersey Historical Society; the 
Library of the American Medical Association ; the National Medical 
Library at Washington, D. C. ; the College of Physicians and Sur- 
geons of Philadelphia, Pa., and the New York Academy of Medicine. 

Exchanges have been received from the following States : Alabama 
(with Report of Board of Health and Book of Rules, of Alabama 
Medical Association), Colorado, California, Connecticut, Illinois, 
Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Minnesota, 
Mississippi, Missouri, Nebraska, North Carolina, New Hampshire, 
New York, Ohio, South Carolina, South Dakota, Tennessee, Texas, 
Virginia, West Virginia, Wisconsin, with the Proceedings, also, of 
the College of Physicians and Surgeons, of Philadelphia, and the New 
York Academy of Medicine. 

Respectfully submitted, 

E. L. B. GODFREY, 

Corresponding Secretary. 



yo MEDICAL SOCIETY OF NEW JERSEY. 



[APPENDIX No. II.] 



Treasurer's Report. 



Dr. Archibald Mercer, Treasurer, in account with The Medical 
Society of New Jersey : 

1892. Dr, 

June. Atlantic County Assessment (18 00 

Bergen " •' 23 00 

Burlington " " 26 00 

Camden " " 55 00 

Cape May '* " ... 16 00 

Cumberland" " 25 00 

Essex " " 145 00 

Gloucester ** " 8 00 

Hudson •* " 40 00 

Hunterdon " *' 18 00 

Mercer *' " 46 00 

Middlesex " •* 21 00 

Monmouth " " 33 00 

Morris " " 3400 

Ocean ** '* 1000 

Passaic '* '* 5 1 00 

Salem " •* 1 5 00 

Somerset *' ** 1700 

Sussex •* " 26 00 

Union " " 44 00 

Warren " ** 20 00 

$691 00 

To Cash in hand June, 1892 1,980 18 

Interest on U. S. Bonds 102 00 

U. S. Bonds 2,250 00 

,023 18 



APPENDIX TO THE MINUTES. 



71 



1892. Cr. 

June. By paid William Pierson, Secretary 

William Elmer, Corresponding Secretary . 



« 



«{ 



ti 



J. L. Murphy Publishing Co. 

H. P. Morehead 

Archibald Mercer, Treasurer 

Henry L. Coit, for Committee 

D. C. English, Standing Committee. . ^ 

F. W. Baldwin, Orange Chronicle, 

R. C. Shultz, Stenographer 

L. J. Hardham, Transactions 



$16 


00 


I 


2S 


9 94 


4 50 


10 


00 


5 


73 


15 


30 


19 


56 


II 


25 


50 


00 


607 


79 



$751 32 

By Cash balance in bank, June, 1893 2,021 86 

By U. S. Bonds 2,250 00 



$5,023 18 



PRESIDENT'S ADDRESS, 

By Geo. T. Welch, M. D , Passaic, N. J. 



Therapeutical Superstition. 

Recent researches into obsolete medical works have 
convinced me that, an old scientific book is not more 
valuable in any other way, than it is in what it represents 
as a landmark of the attainment of thought and specu- 
lation up to the very hour that it issued from the press. 
Truth changes its aspect ; what we have thought was an 
eternal principle, was some issue caught motionless at a 
turn of the tide. When we have believed penetration 
could go no further, some fresher genius has taken the 
trail and disappeared, after shining for a moment upon a 
further upland. 

The Romans erected arches to victory, and columns in 
remote provinces to mark their ever-widening boundaries. 
Beyond many of these flowed the human tide, rising in 
continued swells of grandeur to this hour ; but some of 
them are to be found by chance travellers, in deserts, and 
some have moldered quite away in vast solitudes. And 
just as these ancient and daring conquerors marked their 
latest triumphs with monumental shafts and sculpture, 
on which were graven battles and the names of heroes, 
so, in our books, the great teachers and historians of our 
art have celebrated the achievements of the profession 
and recorded the long roll of illustrious physicians. 
Some of these books, even so far back as the famous 



74 MEDICAL SOCIETY OF NEW JERSEY., 

one of Hippocrates, have been guides co prosperity, 
while others have been shunned as pointing the way to 
haunts of superstition and morasses of the human mind. 
We smile superiorly when we look at some of them 
and perceive how very little had been wrested from ignor- 
ance and credulity, while the book itself is so pretentious. 
And yet every recruit, every appliance of skill, wisdom 
of the fathers, resource of the sons, drift of theories, 
fragments of tradition, charms even, and necromancy, all 
that was believed and all that was hoped, were brought 
together under the standard that was borne thus far into 
the wilderness — the Scythia that besets us with diffi- 
culties, and every morning presents a further horizon. 
And the latest book has brought all up to date, and with 
an unremitting courage the author has placed another 
shaft to victory, which we begin already to leave a day's 
journey behind us. 

. Nothing is established, nothing is sure, is a hopeless 
cry sometimes heard, but, like the Roman, we leave a 
regent in every conquered province, where, if the court 
shifts and the elements revolve, we still govern upon 
principles that defend us. Nor have we any reason to 
feel the superiority of any other profession above our 
own when we reflect that all alike are humbled before 
vast problems, and either feel their way with caution or 
are rebuked by the judgment of posterity. The austere 
creeds of the theologian are constantly crumbling. That 
which must be defended is no longer impregnable. 
Divinity is breaking into a thousand sects. The amelior- 
ating, humanizing principle is abroad. Some of the 
weaker minds, not daring to try the issue, are for leading 
their flocks back into the old paths. They spurn their 
natural leaders and contemn them as outlaws, while with 
vestments and rituals they seek to lull the human mind. 



president's address. 75 

They had as well seek to bind the floods with cassock 
bands, and seal the cave of the winds with threats and 
excommunication. 

Should we turn to statesmanship, we find armed 
neutrality. The invention is sterile that dares not 
dare. And yet, empires are but maps of an hour. 
Slight incursions change boundaries. In law we approach 
the exasperation of politics. It is always changing and 
never satisfactory. It is a net that draws hard upon the 
petty criminal, but bursts when- a corporation is en- 
tangled. Descartes found a whole library in the human 
body, but your lawyer, confronted with a perplexing 
cause, goes to a myriad of books to find his clues. We 
fret and repine because every physician that prescribes 
for an ailment is not a trained scholar in his profession, 
and we fulminate about it so much that, mistaking our 
conscientious care for an admission, the other professions 
smirk and grimmace, but the egotist with the longest 
purse goes to the senate and the ruffian with the greatest 
saloon interest becomes the lawmaker for a state. In the 
cabinet there is vaccillation, in the senate great measures 
stagnate, in the legislature partisanship predominates. 
Smirk hirelings climb the pulpit — " the hungry sheep 
look up and are not fed.** In the natural sciences the 
savants are still classifying. The astronomer is not sure 
that his burned-out suns may not be stars about to 
germinate. 

In the face of all this dilettanteism, what reason have 
we to stand at bay ? We have gone far and have estab- 
lished much. No one will deny the potency of Jenner's 
vaccine, or Lister's antiseptic methods, and all that goes 
under the comprehensive title of hygiene. The study of 
preventable causes of disease is raising the standard of 
medicine, and just as physicians recognize that their 



76 MEDICAL SOCIETY OF NEW JERSEY. 

mission in a wider one than the mere administering of 
drugs to cure the ill, will they exalt their profession and 
become an established power in government. For if we 
exclude from the human family all the preventable dis- 
eases, and those produced by worry and mental strain, 
by physical strain, the excesses of the passions, by alco- 
hol, tobacco, narcotics, unwholesome foods, impure air, 
by occupation, sloth and idleness, late hours and broken 
sleep, errors of dress, imitation and moral contagion, 
automatic diseases and hypochondriasis — all of which are 
evils that can be avoided — how small a percentage would 
be left for the doubtful compounds of the pharmacopia. 
"If intermarriage of diseases were considered in the same 
light as intermarriage of poverty, hereditary transmission 
of disease, the ba^is of so much misery in the world, 
would be at an end in three or four generations." — Rich- 
ardson. Thfere will come a day early in the next century 
when a Secretary of Health will be as necessary a mem- 
ber of the Cabinet as he who holds the portfolio of Law 
or Agriculture. 

That this has not been so long ago in all countries is 
not so much the fault of a progressive profession as it is 
of a vicious education in therapeutics. However man 
may deteriorate his health, however long he may have 
put at defiance every law of nature, he demands an in- 
stant cure. He may scoff at miracles elsewhere in the 
natural world, but he confidently expects one at the 
hands of his physician at any hour, let the disease be 
what it may. And the physicians are few who boldly 
stem this senseless tide. The majority yield to it ; go 
with the current, pander the superstition. Vainly they 
offer this or that panacea, and painfully reminded by past 
experience that the discouraged patient may suddenly 
leave and go to the coast of some other Bohemia, they 



president's address. 77 

make a dizzy change from drug to drug, but the demon 
of disease looks out and leers at them. He will not be 
propitiated or poisoned in his keep. 

To have perfection in the child, says Holmes, we must 
begin with his grandfather, and in morals no man expects 
that a clergyman hastily called in will by some hocus 
pocus make saint of one who, long a sinner, has at length 
committed some atrocious crime. The mills of the Gods 
grind slowly — and human laws are inexorable, too. The 
transgressor finds to his cost that he must endure many 
fluctuations of hope, many fines and penalties, for the de- 
lays of the law are proverbial. There are, it is true, many 
ephemeral laws, such as have scourged us at Trenton 
since booted and spurred the jockeys have ridden the 
state till the galled jade winces, but the Supreme Court 
has remedied these right speedily, and so there are 
ephemeral diseases that Nature will right and which must 
succumb of themselves. And without cavail it is in the 
self-limited diseases that the incessant therapeutist has 
won his most signal triumphs. Like the fox in the fable, 
he has a thousand tricks by which he can baffle the acute 
assaults of la grippe, pleuritis, bronchitis, asthma, per- 
tussis, endocarditis, dysentery, chorea, rubeola, deugne 
and acute rheumatism, for these are diseases whose ten- 
dency is to recovery. But he is less brilliant when pitted 
against croupous pneumonia, laryngitis, croup, oedema of 
the glottis, angina pectoris, acute gastritis, cholera, peri- 
tonitis, hepatitis, apoplexy, meningitis, tetanus, typhus 
fever, yellow fever, smallpox and diphtheria, for these are 
dangerous diseases. 

He is restless and feels the prescience of defeat, though 
still dosing the adversary largely, when it comes to a con- 
flict with the chronic diseases, such as general paralysis, 
paralysis agitans, phthisis, epilepsy, progressive locomo- 



78 MEDICAL SOCIETY OF NEW JERSEY. 

tor ataxia and Bright's disease. He is obliged to sit 
down to a regular seige before all the diseases which, 
though acute at first, have become chronic in spite of all 
his drugs. For disasters like these he has numberless ex- 
cuses — as that the patient was already debilitated, he con- 
tracted a cold, there were complications, an unmanage- 
able diathesis was awakened. And then come the in- 
curable diseases, such as gastric ulcer, carcinoma, cirrhosis 
of the liver, acute atrophy of the liver, and chronic 
diffuse nephritis. In the presence of these the most in- 
veterate dispenser of drugs, seeing the death warrant, 
patent to all eyes but his who must suffer and endure, 
must stand humbled amid his pots and vials. He must, 
else, pour his libations in vain. 

And is it not singular that drugs should be esteemed so 
powerful in the acute, self-limited diseases, and yet in the 
chronic types, where the opportunities for their potency 
is so prolonged, they should fail so signally? 

As knowledge accumulates, this or that drug of the 
fathers, which was wont to be so irresistible in fevers, in 
imposthumes, or what not, is laid upon the shelf. We 
now know and can demonstrate that it was utterly use- 
less, and yet the patient often got well ! 5very physi- 
cian who has been spared to a great age can look back 
upon pharmacies ever changing. On the Ariel-wings of 
memory he can glance into a thousand sick rooms and 
sniff the odors of drugs no longer known. They had 
their day and the fashion changed. 

Men couldn't be soundly cured without calomel, once, 
and veratrum viride was a later triumph. Cod liver oil 
was once the Utopian remedy for phthisis. And it is 
astonishing how even an enthusastic therapeutist can 
always find the improvement his horoscope has forecast. 
But in fact he is only the antipode of the specialist who 



president's address. 79 

is never known to examine a subject who has not some- 
thing wrong in his line of business. Dr. Wood, in the 
fourth edition of his Practice of Medicine, 1855, gives 
what may be taken as the average view of the physicians 
of the day in regard to the benefits of cod liver oil in 
phthisis, for the old professor was never rash, but we shall 
find that his opinion was tinted by the prevailing senti- 
ment. ** It does not act as a specific," says he, ** and is 
wholly incapable of producing, by any direct influence of 
its own, the removal of the deposited tuberculous matter. 
But it invigorates digestion, improves the character of 
the blood, and by a pecular power modifies the nutritive 
process so as to obviate in a greater or less degree the 
tendency to the deposition of tuberculous matter." 

Now I question whether it is the experience of any 
scrutinizing physician to-day that cod liver oil invigorates 
the digestion ; if it did, it would be the remedy par ex- 
cellence, for the natural history of the disease in question 
shows that the fatal result is at length brought about by 
the gradual undermining and impairment of the appetite 
and digestion, which, once destroyed, the whole fabric col- 
lapses. And of all animal substances given to a healthy 
man, we shall find the injestion of fats furnishes the most 
serious problem for the functional processes of the 
stomach and intestines. Now, long before J. Hughes 
Bennett voiced the popular impression that the origin of 
phthisis is due to defective fat-digestion, it was the 
unwritten law that strumous indigestion and the in- 
digestion of fats were synonymous terms. And not even 
a knight-errand in medicine would now deny the con- 
nection of the indigestion of fats with the strumous 
diathesis. The healthy stomach that has not been ap- 
palled by sweets and sours, and fats and leans, hot fluids 
and ices, dry wines and sparkling, and all the menu of a 



8o MEDICAL SOCIETY OF NEW JERSEY. 

modern dinner of state, may also digest cod liver oil 
mixed with ordinary food, but if more than a moderate 
amount is added the digestion becomes deranged with all 
the hideous symptoms dyspeptics are so fond of confiding. 
What then of the stomach already far gone ? Would you 
load a staggering porter with a few pounds more every 
time he faltered past you, on the theory that it would im- 
prove his strength ? 

When I was a student in the university and hospitals 
in Philadelphia, solutions and syrups of bromide of 
potassium were the popular tipple for all sorts of diseases, 
and quinine became the universal panacea for the laity 
just as it was losing ground with the profession, but the 
coal tar derivatives are pushing all others to the wall. 
The chemists would seem to have gone mad in their 
laboratories and to have applied the match to a new sys- 
tem of fireworks, so bewildering are their nimble cor- 
ruscations of saccharine, pyrodin, hydroxylamine, metha- 
cetin, thalin and exalgin. But the sparks die out as 
suddenly as they astonished, and many of them are 
already forgotten. 

When it comes to this, that most of the self-limited 
diseases will get well without drugs, that some of the 
acute diseases with unfavorable complications got well in 
the previous generation and in the centuries gone, under 
the prescription of drugs now known either to have been 
inert or misapplied, and when we recognize the fact that 
within five years the medical journals teemed with en- 
comiums of new drugs which are already superseded by 
others, which in their turn are getting a little passe, the 
confused physician may well exclaim with the dazed 
political vivant: "Where am I at?'* He might feel his 
faith seriously shaken when he recalled how sadly he had 
been duped by the old pharmacologists and the organic 
chemists of the hour. 



president's address. 8 1 

When we regard the fact that the earth everywhere, 
unless depopulated by merciless greed, is teeming with 
animal life in the highest state of perfection, which has 
been evolved from parent to parent through unmeasured 
aeons, and that in his savage state man himself, until cor- 
rupted by his civilized congener, has been found to be 
of fascinating feature and vigor, we must admit that 
drugs have not been necessary tp perpetuate and 
strengthen the races. And when we reflect that, though 
the complex forces of civilization have induced a variety 
of diseases, many of them are preventable and many of 
them self-limited, and therefore to be got rid of without 
drugs, and that the chronic forms of disease resist drugs, 
and that upon the whole the bills of mortality have not 
been lessened by them, we must conclude that our pro- 
fession has given altogether too much prominence to the 
apothecaries* art and raised expectations in the minds of 
the ill which cannot be realized. Further, it has set upon 
them hordes of charlatans, which, like evil birds, batten 
upon human miseries. It is time that we should reform 
ourselves and convince the public that there are higher 
potencies than the therapeutical superstitions that we 
have dealt out to them. We detest and execrate the 
priesthood for driving a shrewd trade with the bones and 
relics and other useless lumber of the saints, but we have 
unconsciously set up a barter of a like kind, and need to 
have our temple scourged of the money-changers, too. 

I am aware that it will be urged that the average 
physician of to-day is much more wary in the use of 
drugs, and that upon the whole, smaller doses prevail and 
greater discrimination is exercised. I have heard, too, 
that the world has grown better, wars less numerous, man 
more concerned in raising his" neighbor than in raising 
himself on his neighbor. But I note that the sentinels of 



82 



MEDICAL SOCIETY OF NEW JERSEY. 



old empires grimly regard each other across the borders ; 
that Justice in the South is not only blindfolded, but has 
her hands tied willingly behind her back; that the saloon 
domineers our politics; that the shadow of the prison 
falls across the threshold of the temple. And I know 
that in 1889 there were imported into this country 
$13,186,290 worth of drugs, used in medicine, and that 
the succeeding years have not shown a less amount. I 
know, too, that there has been no inverse ratio existing 
between the pharmacies and the physicians. In an essay 
on this topic in 1889 I showed from the statistics of com- 
merce and navigation of the United States for the year 
ending June 30th, the gross amount in pounds of the chief 
drugs used in practice which were imported to that date. 
I have just received from the Secretary of the Treasury 
the volume containing the statistics of the importations 
for the year ending June 30, 1892, and I find the follow- 
ing startling items: 

Quinia Sulph 2,686,677 ounces. 

Cautharadics 10,446 pounds. 

Balsam Copavia 206,0 1 1 

Aloes 255,394 

Assafoetida 125,557 

Ipecac 38,329 

Jalap ii2,6oc 

Manna 49*335 

Ergot 125,148 

Cubebs II 5,974 

Nux Vomica i ,392,437 

Opium (9 per cent, morphia) 587, 1 2 1 

Rhubarb 11 8,874 

Salacine 5, * 52 

Morphia, and all salts thereof 42,301 ounces. 

Calomel and other mercurial medical 

preparations 1 2,630 pounds. 

Alkaloids and alkalies to the amount worth $827,230. 



president's address. 83 

Certainly, no one can complain that there will not be 
enough to go round ! Every mail is turgid with the 
pleas of manufacturing druggists. Our daily papers and 
the religious weeklies are insidiously padded with the 
advertisements of cure-alls. Postal cards, like so many 
tormenting gadflies, are pestering the sixty odd thousand 
physicians of America with the information that this or 
that compound is the only safe remedy for lung, kidney 
or brain diseases. And these drugs do not pass into 
innocuous desuetude — they are used somewhere. Who- 
ever has had the curiosity to read the minor medical 
journals that he might know what is going on in the under 
world, must have been struck with the therapeutic greed 
of the writers — practical fdlows who go scrambling crab- 
wise over pathology to seize proprietory mixtures which 
are labelled to cure all the ills under the evil planets. 
The quacks grown wary, having been beaten off the field 
by the tremendous reinforcements in the medical ranks, 
return to vend their wares to the physicians themselves. 

I have searched a large number of the pamphlets and 
medical journals of all classes during the past three 
months, so that I might note the therapeutical extremes 
in this quarter of the latest year of the closing century. 
Brown-S6quard and his disciples are patiently engaged in 
the injections of organic liquids. He is not rejuvenating 
octagenerians with spermatin so frequently and success- 
fully as at the first blush, in 1889, ^^^ ^^ records here 
and there in a dreary waste of experiments that extract 
of the thyroid gland injected into somebody with 
myxoedema has metamorphosed the patient. Constan- 
tin Paul and Prof. Babes are transfusing extract of the 
gray matter for neurasthenia. Injections of the extract 
of pancreas are being tried for diabetes. In diseases of 
the heart, injections have been made with the extract of 



84 MEDICAL SOCIETY OF NEW JERSEY. 

cardiac muscle. Dieulafoy has tried injections of ex- 
tract of kidney on a man affected with uremia. Dr. Paul 
Gibier kindly announces, through a contributor in 
his own journal, that he has tried extract of cat 
muscle in cases of progressive muscular atrophy after 
failure with other methods, and gracefully adds that, "he 
will probably report later on this subject." Dr. William 
H. Hammond, with fine insista-nce, appropriates all ex- 
cept the hint from Brown-S6quard of this fantastic 
pharmacology. He has made alkaloids of the dif- 
ferent organs and portions of the ox, and proposes to 
do away with all other drugs arid cure and renew like 
with like, giving an eye for an eye and a tooth for a 
tooth, like the Hebrews of old, while he opens up new 
fields to the apothecaries beyond the dreams of 
avarice. The medicine will come dear, but so all 
things do in art, and it is the simplicity and 
ready applicability of the remedies that must recom- 
mend them. Dr. Hammond questions whether among 
all the teeming brains that have swelled and broken on 
the shores of time, such a solution of the vexed question 
of therapeutics has ever presented itself, though dimly 
conscious that he may have heard of some old German 
who speculated on the probable results of giving a liver 
diet to men diseased in the liver. 

What pain it is to a great inventor to find that his 
speculations were distilling long ago in the alembic of 
another's brain ! And yet so active have been men's 
minds that there are few things said, done, or conjectured, 
but that the spark was struck forth in immemorial days. 
** Eighteen very old men," said Theodore Parker, " could 
touch hands back to the birth of Christ," and in my 
researches into old books I never yet found one that did 
not allude to some book more ancient still, and to names 



president's address. 85 

of scholars of dates still beyond, whose monographs and 
treatises have clean moldered away in the crypts of time. 
As far out from the central darkness of the Middle Ages 
as the seventeenth century, I find in Schroder's Chymical 
Dispensatory, 1669, that the physicians of his day, upon 
the same hypothesis that Hammond has proceeded, arid 
Brown-S^quard before him, used the different animal 
glands and tissues in medicine for the cure of distempers 
in corresponding parts in man. The work of Culpepper, 
1653, gives some recipes for preparing fox lungs into a 
loloch for the cure of asthmas and inflammation of the 
lungs, and he recommends duck livers as being exceed- 
ingly strengthening to the liver. But Schroder, whom 
Cullen respectfully criticises as an authority in his day, is 
more elaborate in his treatise and quotes from Crato, 
Baubin, Jordan, Libavius, Crollus and others, now no 
longer obtainable, as I am told by librarians whom I have 
consulted. In his fifth book. Zoology, he treats of that 
" Part of Pharmacy that shews what Medicines are to be 
taken from Animals," and he gives, with anxious con- 
cern, explicit directions for the choice of animals that 
** have no diseased dispositions," and orders that they 
shall be killed by external violence to the end that ** the 
medicamental substances of everything fit to act shall be 
without diseases and full of wholesome tinctures." 

For the relief of impotence in the man, or sterility in 
women, he recommends the testes of the boar, and quotes 
Schwenkfield as an authority for the use of the same 
glands from the stag for a similar purpose. For diseases 
of the liver he urges the use of the liver of the calf, the 
hare, the wolf and the fox. The spleen of the calf and 
of the fox, he asserts, will cure diseases of the spleen, and 
lung diseases are benefited by medicines made from the 
lungs of the fox. Drachm doses of the powder of wolfs 



86 MEDICAL SOCIETY OF NEW JERSEY. 

intestines would cure colics. The dried uterus of the 
hare " taken after the terms would help conception." 
For weakness of the bladder he directs a sheep's or goat's 
bladder to be calcined and given. 

In the first and second books of his Dispensatory he 
gives at great length the methods to be employed in pre- 
paring these animal drugs for exhibition. 

But more daring than our modern therapeutists, he 
deals with the body of man himself, as being so much 
good material for medicine that it should not be wasted 
on a final resurrection, but should be raised up in the 
living body of those who languish. The physicians of 
the day employed in their practice the following parts 
and excrements of the living body of man : The hair, 
nails, saliva, perspiration, milk, secundines, spermatic 
fluid, the blood, and things unmentionable. And from 
the dead body, the flesh, the skin, the oil, the bones, the 
brain, gall and heart. The hair was said to breed hair, 
and a distilled liquor was made thereof, with honey, for 
the purpose. The sweat, seeing that it exuded from the 
glands, was good against scrofula. The secundines, 
calcined and given in southernwood water, cast out moles 
and children dead. From the semen was made a mag- 
netic mummy to cause love, and, as Schroder quaintly 
puts it, ** Paracelsus makes his little man thereof.** The 
blood, drunk hot, cured epilepsy. Applied to nose or 
skin it stopped hemorrhages. An oil extracted from it 
cured consumptions. A balsam was made of it to cure 
the gout. Dried gently and impregnated with spirit of 
lemons or vitriol, and made into troches with myrrh, it 
cured carbuncles. 

The brain of a young man under twenty-four, who had 
died of violence, was taken by the chemist, with all its 
membranes, arteries, veins and nerves, and beaten in a 



PRESIDENT'S ADDRESS. 87 

mortar; to this was added the waters of tile flowers, 
piony, bettony, black cherries, lavender, lilly-convals, 
until it was covered four inches. After standing awhile 
it was distilled and became "a brave antepileptick.** 
Salt added to the brain, and the whole distilled in a glass 
retort in the sand, was used to strengthen the living brain. 
He tells us ** if we would have more medicines made 
from man we should read the particular Tractate of 
Becker, in Quarto.*' 

But Dr. Shoemaker, of Philadelphia, less aspiring, 
could, if he would, cure anything with Kola nut. 
Kola nut, chemically considered, contains about 2.3 per 
cent, of an alkaloid analagous to theine or caffeine, 0.023 
per cent, of theobromine, together with tannic acid, 
sugar, albumin, cellulose, starch, fat and fixed salts. 
Mild enough, but with this Shoemaker had excellent 
results in migraine, the acute pain soon subsiding, the 
vomiting was relieved, and the patient entering upon a 
convalescence slow as usual, but more rapid than he had 
expected. (Nov/ migraine naturally takes an increasing 
course until vomiting occurs, shortly after which the 
patient is relieved and usually falls into a sleep, from 
which he awakes free from the headache.) 

In the case of a girl of sixteen, whose condition was 
due to excessive school tasks in a hot, ill-ventilated 
room, without outdoor exercise. Kola brought about an 
entire change. Under its use, and withdrawal from 
school, she soon regained a good appetite, her headache 
left and she became able to sleep at night, and, as he 
delicately puts it, " she now has the conrage to pass a 
certain portion of every day in the open air." (All of 
which would have occurred on the girl's withdrawal from 
school if the Kola nut had been still in Africa.) 

But he did not pause after these triumphs. He got 



88 MEDICAL SOCIETY OF NEW JERSEY. 

good results from Kola in melancholia, neuralgia, ulnar 
neuritis, spurious locomotor ataxia, gastro-intestinal 
irritability, irregular heart, tuberculosis, dyspepsia, gastro- 
enteritis, renal irritation — in fact he had a whole Phila- 
delphia drug store in a Kola nut ! He even cured boils 
with it, after he had first evacuated the pus! If I have 
done this unconscious humorist wrong, I can but 
recommend Kola nut to his attention. 

A sturdier faith never prompted any man to hug the 
iron that wounded him than appears in Dr. J. S. Whit- 
mire, of Metamora, 111., who for the cure a cerebral 
rheumatism took black cohosh, iron, quinine, strychnia 
and iodide of potash every four hours, together with 
phosphate of soda and tincture of digitalis every six 
hours. In one month he had taken one hundred and 
eighty drachms of cohosh, three grains of strychnia, one 
hundred and eighty grains of quinine, three drachms of 
iron, nearly two pounds of the phosphate of soda, besides 
his digitalis and iodide of potash. He then went to bed 
and changed his drug diet to ergot, gelsemium, hyos- 
cyamus and citrate of potash. At the end of ten days, 
having got no relief, he was put on extract of manaca, 
citrate of potash, strychnia, quinine, iron and cactus. 
Being no better at the end of fifteen days, ergot was 
added and citrate of lithium. In two weeks more he 
was convalescent, and at last accounts he was tapering 
off on iron, strychnia, quinine and hydrodic acid. Here, 
evidently, was a man who had nursed himself on poisons 
from his infancy, and in his cheerful old age he could 
have lain down among vipers and have defied the 
Borgias. 

I might quote largely from minor sources — of the New 
York young man who gives continued doses of citrate of 
potash, sweet spirits of nitre, acetate of ammonia and in- 



president's address. 89 

fusion of digitalis to a man who has not urinated for ten 
days, and at length, under the influence of a consultant, 
introduces a catheter for the first time, and finding no 
urine, changes his therapeutic tactics; of the practitioner 
who gives to a lady in Chicago, for follicular tonsilitis, 
within an hour, ten drops of tincture of belladonna, three 
drops of tincture of aconite and two five-grain doses of 
antipyrin, and then, because the patient declared herself 
morbidly susceptible to the influence of quinine and 
begged that he should not give that to her, too, he pro- 
ceeds to order a morning dose of it. Hastily summoned at 
8 A. M., he as hastily concludes that the belladonna rash 
has been caused by his one grain of quinine. For no ap- 
parent reason, except for psychical purposes, he now 
gives her ten drops of tincture of nux vomica and goes 
home to exploit his feat in a medical journal. But I 
shall refrain from further illustration, only observing that 
this sort of dosing is going on on all sides of us. 

For, from times immemorial men have believed in some 
preternatural power in drugs; even the occult sciences 
have been invoked to assist in clouding any process of 
reasoning on their qualities. Every this or that was 
under the dominion of some planet, which infused into it 
the virtues or vices of the heathen god under which it 
flourished. But, whatever the drug, it had its inevitable 
rrse and decline. As thus, from Culpepper, 1653, of the 
Amara Dulcis: " It is under the planet Mercury, and a 
notable herb of his also, if it be rightly gathered under 
his influence. It is excellently good to remove witch- 
craft, both in men and beasts, as also all sudden diseases 
whatsoever. Being tied round about the neck, it is one 
of the most admirable remedies for vertigo or dizziness 
in the head ; and that is the reason (as Tragus saith,) the 
people in Germany commonly hang it about their cattle's 



90 MEDICAL SOCIETV OF NEW JERSEY. 

necks when they fear any such evil hath betided them. 
Take notice it is a Mercurial herb, and therefore of very 
subtile parts, as indeed all Mercurial plants are." As far 
on as 1815 I find records of the esteem in which thera- 
peutists held the amara dulcis. It would " remove felons, 
open obstructions of the liver and spleen, help difficult 
breathing, bruises and falls, and remove congealed blood 
in any part of the body, besides being useful in yellow 
jaundice, black jaundice and dropsy.'* 

At the close of the nineteenth century we are too 
ennuied to smile at the myths of ancient theology, and 
the god Mercury has lost his grip on the dulcimara, but 
it is still recorded in our therapeutics as a remedy ** for 
cutaneous eruptions, for chronic muscular rheumatism, 
chronic bronchitis, whooping cough, and other chronic 
pulrponary affections, but," it is added, " it must be 
long continued to produce curative effects.*' Many 
patient drug-swallowers must have believed themselves 
in process of time to have been cured by this drug of 
their chronic invalidism, to the sedate gratification of the 
long-winded physicians who prescribed it. But, note 
you, in the seventeenth and eighteenth centuries it cured 
sudden diseases, while for seventy-five years back it has 
only been good for chronic diseases, and now it is rarely 
given, so low has its popularity waned. And in recent 
years Dr. John Harley laboriously experimented upo,n 
man with its expressed juice and tinctures, in small doses 
and in large, without any appreciable physiological effect 
whatever. 

Would that as much could be said of many another 
drug that is wont to be used in season and out of season, 
for some of them in unguarded hands exert as desperate 
effects as the diseases they are reported to cure. The 
largely increased use of ergot in uterine disorders, and its 



president's address. 91 

long continuance in special cases, must bring about its 
physiological effects in time. A lady who came under my 
care had taken the fluid extract in drachm doses on 
certain days in each month for two or three years, under 
the advice of a physician in a neighboring city, until she 
at length had feeble digestion, impaired vision, men- 
orrhagia, increasing languor, slow pulse and respiration, 
and an abnormally low temperature. When the drug 
was prohibited she gradually recovered, during as many 
years, from its deplorable effects. 

How many physicians know anything of the natural 
course of most diseases except by hearsay? How many 
have had the courage to observe for themselves while 
sternly combating the seductive opportunity of prescrib- 
ing a variety of unnecessary medicines? Most diseases, 
as they are met in practice, are so overlaid, disguised and 
their symptoms colored and mingled with the effects of 
drugs that have been administered, that only a mongrel 
type is known to the profession. The skilled and 
philosophical consultant views the case ascant until he in- 
quires what drugs have been prescribed. 

Quinine, though fallen from its high estate, and passing 
into the hands of the laity as an universal panacea, is 
still given frequently by the profession for a variety of 
disorders. It is given promptly, largely and even hys- 
terically in conjestive intermittents, but its physiological 
effect is to cause the face to become suffused, the pupils 
dilated, the pulse accelerated, with coma and sterterous 
breathing. How shall we divine between these lethal 
effects of disease and drug? Few recover from the con- 
gestive intermittent and few recover from poisonous 
doses of quinine. 

How often is gelsemium prescribed in neuralgias, con- 
gestions of the brain and in sthenic febrile diseases, and 



92 MEDICAL SOCIETY OF NEW JERSEY. 

yet even minute doses of this drug have caused alarming 
symptoms — the face becomes congested, the pupils 
dilated, the respiration slow, the brain dizzy, and death 
not seldom follows. 

Copaiba is a favorite remedy with most physicians in 
vesical catarrh, but the continued use of copaiba renders 
the urine darker and turbid, and irritates the bladder, 
causing micturation and sometimes haematuria. 

Typhoid fever persists, ferocious, undeviating, in spite 
of the fifty odd drugs prescribed by the variety of 
physicians in attendance on a given number of cases. 
Some of the patients lie muttering under the spell of 
alcohol, some in extreme hebitude of mind lie dazed 
under the swooning influence of enormous doses of 
quinine, some lie weltering in the perspiration induced 
by antipyrin, but all who do not die beforetimes continue 
to be prey of the riotous fiend just the same as if no 
powerful drug had been administered. And yet who 
dare aver that active medication does not imperil the 
sick man's chances? 

Think of the saturnalia of drugs that has been ad- 
ministered for the relief and cure of hysteria ! ^ther, 
amber, amyl, assafoetida, camphor, castor, dracontium, 
galega, musk, narcissus, succini, parthenium, lead, bro- 
mides, primula, ruta, houseleek, mustard, rosmary, 
sumbul, tansy, linden, and thirty more. In the main all 
useless, for where isolation, psychic treatment, hydro- 
therapy, mechanotherapy, and perhaps electrotherapy, 
fail, outside of the valerianates and three or four other 
drugs, the whole host beside but aggravate the paroxysms. 
The better the diagnostician, the simpler the prescription. 
The physician, confused by the disease, defends himself 
with a confusion of drugs. The less confidence he has 
in himself the larger the army does the general gather 



president's address. 93 

about him, desiring to crush by numbers where skill can- 
not avail. 

There is a disease that ravages the earth and many a 
plumed knight has gone forth to conquer it, and has been 
himself conquered in turn. It selects its victims in hovels 
and in palaces, and gloats equally upon the beggar, the 
prince, the dullard, the artist and the poet, the lady with 
the camellias and the sewing girl in her garret. Its 
stealthy tread is not only in country by-ways, but it 
walks unseen in the populous mart. It destroys more 
lives than any other disease, not excluding the pestilence 
of cholera. Like that dread Angel of the Judgment, it 
enters all families, chooses, and is gone. So softly has it 
stolen that not even the parent is aware, and the solicit- 
ous lover sees only a more etherial beauty in the face 
that is soon to become but a memory in his soul. Her 
face is flushed with kindlings of eternity, and her eyes 
grow large and lustrous and fixed in their pathos, as 
though she held reveries with unseen bands. So rapt is 
she that she feels not the cruel fangs upon her vitals, and 
were it not for the low cough that betrays the demon at 
his sacrificial feast, we, too, should be deluded into think- 
ing that the tuberculosis had abandoned his victim. 

We try a hundred schemes to balk him and to rout 
him from the field. Iodoform, aniline, thymol, ozone, 
corrosive sublimate, hydrofluoric acid, inhalations of car- 
bolic acid, creosote, iodine, eucalyptol, turpentine, 
sulphurous acid, chlorine, sulphuretted hydrogen ; intra- 
pulmonary injections of iodol, camphor-carbolate, napthol, 
gnaiacol ; the introduction of the bacterium termo to war 
upon its natural foe, the bacillus tuberculosis ; Liebrich*s 
injections of cautharidinate of potash; subcutaneous in- 
jections of goat's blood, dog's serum ; Koch's tuberculin 
and Brown-S^quard's fluid. {Shrady.) But the end is 



94 MEDICAL SOCIETY OF NEW JERSEY. 

the same. Unless we resort to the ameliorating in- 
fluences of climate, after all is done, we have tortured in 
vain. 

I am aware that there are members of the profession 
who frequently give medicine not so much from a belief 
that the patient's disease demands it as from an astute 
sense of the fine moral effect it has, for their own benefit, 
on the man's friends. There are people who would be 
clamorously dissatisfied if a relative with an incurable 
disease should not be well dosed on his descent ; very 
much after the fashion of staid old sectarians in out-of- 
the-way neighborhoods, who would be scandalized if one 
should go to heaven without benefit of clergy. And 
then, too, it is a convenient masque to a perplexed spirit 
to be industriously giving something when the case is not 
understood. The doctor's dignity of knowledge is not 
questioned — he is hard at work dosing the obstinate sick 
man — all must be right ! " When I have a case I do not 
understand," confessed an old New York professor, "I 
give iodide of potash." 

If the souls of civilized men on their last journey were 
suddenly rehabilitated in flesh and marched before skill- 
ful judges it could be told in large measure to what doc- 
tors these one-time patients had belonged. One drove 
would be found branded with tincture of iodine wherever 
there had been a swelling or a pain. Some would have 
been snipped in their noses by the perfunctory laryngol- 
ogist Here would come a platoon wearing plasters; 
another sopped with poultices; a third would have been 
blistered most cruelly by the inexorable quidnuncs that 
attended them. Drunkards, with skins stabbed thick 
with Keeley's motors, would go reeling by. Women 
without ovaries. Troops of sad wretches slain by fever, 
their stomachs corroded with a diversity of drugs. Hos- 



president's address. 95 

pital patients yet swathed in bandages, from experi- 
mental operations on hopeless diseases. Epileptics, 
hideous from bomism. Paralytics, yet quivering and 
gyrating, scarce escaped from the electrician. The wan 
victims of phthisis eloping in a mist of sprays by day 
and pursued by hypodermic spearmen at night. 

For, after all these interminable centuries of dosing and 
the ultimate skill arrived at in the profession in the 
selection and application of the drugs, there is no dif- 
ference in the mortality rate of most diseases from what 
it formerly was. The death-rate for New York city in 
1892 was 24; and during the week ending April i, of the 
current year, it was 33.2. And for the year ending June 
30, 1892, it was, in cities of over 5,000 population in New 
Jersey, 24.81 per thousand. In an estimated city popula- 
tion of 870,985, there died below twenty years of age, 
11,217 individuals, or one-seventieth o^ the entire popu- 
lation. 

Surely, here was the strongest incentive of our art to 
rescue the bud and promise of the race, and I doubt not 
but that physicians were zealous and apothecaries 
calculated as they compounded, while the cold, pathetic 
Azriel lingered, but drugs could not stay this crusade to 
the tomb. And upon an individual analysis of the fatal 
diseases in the state for the year ending June 30, as 
aforesaid, I find that 1,008 died of scarlet fever, 1,776 of 
diphtheria and croup, 3,575 of consumption, 5,187 of 
acute lung diseases, 2,242 of brain and nervous diseases 
of children, 2,457 ^^ adult brain and spinal diseases, and 
1,625 of digestive and intestinal diseases. And the 
number of deaths from the chief preventable diseases 
was 11,720. Altogether there died 32,685 out of a 
population of 1,511,653, or, in other words, about one 
forty-sixth of the entire population died last year. If it 



96 MEDICAL SOCIETY OF NEW JERSEY. 

were not for the foreign influx, where would New Jersey 
be in less than a generation, for the deaths exceeded the 
births by 2,058, in spite of the pharmacopea? 

But if this prodding stirs some saturnine brother to re- 
sentment, and he cries out testily: "What, then, have 
drugs done no good ? Are they all equally fallacious and 
dangerous? How are we going to practice medicine 
without them ?*' I must return that you have a very in- 
ferior idea of the profession, indeed, if doctors are only 
to be pill venders. That drugs have done good when 
wisely applied goes without question. We know that 
opium assuages pain, the salicylates conquer rheumatism, 
phenacetin eases headache, pepsine assists digestion, and 
that men in all the diseases have been comforted 
by the apothecary's art. But the mortuary lists of the 
Board of Health can furnish no monument to the living. 
It was Dr. Billings' conclusion in his lecture on Vital and 
Medical Statistics, in 1889, that "although the expecta- 
tion of life is greater, yet this is only true of the earlier 
ages. After a man reaches twenty, his expectation of life 
is less than it was fifty j^-ears ago, for the reason that 
more persons of feeble constitution are now nursed to 
manhood. The decrease in the general mortality is due 
to better care of infants and the prevention of contagious 
disease. So far as statistics show, it does not appear 
that there is any difference in the mortality rate of most 
infectious diseases from what it used to be. Or, if there 
is any difference, it is one which may be attributed to the 
special character of the epidemic, or the age and consti- 
tution of the people." 

This being true, what are we going to do about it? 
The lives of the world are submitted into our hands. We 
have drugged the populace well and they have not 
profited by it. Like great magicians, we have juggled 



president's address. 97 

with drugs and have professed to cast out diseases with 
pellets and fumigation, but we have not assumed the 
sublimer attitude of striking at causes. Are we to be 
like a swarm of lawyers and churchmen, forever follow- 
ing precedent — invited forward by great enterprises, but 
plucked backward by ghostly hands? Here and there a 
lonely reformer appears, but there is no unanimity of the 
profession. The people are apathetic because they have 
not been instructed. Governments are deaf because we 
ourselves have never been impressive. 

In those ideal commonwealths, Plato's Republic, Sir 
Thomas More's Utopia, Bacon's New Atlantis, Cam- 
penella's City of the Sun, the art of medicine was 
given an inferior place, while the lawmaker was exalted 
to the chief station. What a botch the lawmaker has 
made in real life may be read in the uneasiness of all 
lands. But there is a growing anticipation as to the 
exalted mission of our profession which is not confined 
to race or creed. 

Whether the rise and fall of great civilizations is like 
the lifting and subsiding of monster waves, where all at 
length becomes a dead, smooth sea, and where at best 
only a certain exaggerated undulation under the stress of 
fugitive storms is possible, or whether mankind, like a 
race of Titans, sometimes descends into hollows and 
caverns or camps on the edges of deserts for an age, while 
it renews its strength for fresh encounters, and climbs 
again a hfgher range and wrests the secrets of nature from 
the taciturn lips of rocks and under the cold stars 
wrestles with the jealous angel of the Lord, like Jacob of 
old, and holding fast to the divinity conquers its bless- 
ing, time is yet too young for us to tell. 

But if we might indulge in lofty anticipations, which 
the progress of this century would seem to justify, we 

7 



98 MEDICAL SOCIETY OF NEW JERSEY. 

might in our own particular art conjecture that the day 
will come when physicians, as a body of public men, will 
be the true generals of the commonwealth. To them 
will be consigned the preservation of the nation, the 
fighting and eradicating of the microscopic enemies that 
menace more lives and destroy more victims than all the 
standing armies of the world. And where a few thous- 
ands are now grudgingly dolled to the science that seeks 
to foster the lives of men, while millions are voted 
annually to the art that is trained to destroy, the scale 
will be reversed and the public purse will be opened with 
alacrity to the aid of the enterprises of the guardians of 
the race, while the army will be cut to the smallest 
stipend. 

No one disputes now the right of the state to con- 
serve the public health by establishing quarantines, hos- 
pitals, asylums, the regulating of travel and commerce 
from ports of infection, and the general jurisdiction in 
sanitary affairs. It is a function that will in time assume 
vast proportions, and must come under the immediate 
control of the physicians of the commonwealth. 

Under such a regime we may expect that these officers 
of the state will order the affairs of the citizens so that 
no man shall live for private greed, but, as in ancient 
Sparta, each man shall conclude that he was born not for 
himself, but for his country. 

And under all their labors to eradicate infectious dis- 
eases, to enlighten the people in sanitary living ; their 
removal of the tuberculous, the asthmatic, the rheumatic, 
to proper climates; their modeling of tenements, in- 
spection of food, regulating of marriage, these graver 
minds will read that part of our literature with'amused 
contempt and pity, where learned societies waste their 
time in disclosures and debates as to the rival claims of 



president's address. 99 

this or that drug, or combinations of drugs, in the cure 
or relief of yellow fever, diphtheria, scarlatina, typhoid 
fever and cholera, instead of striking at the root of these 
scourges, and with an overwhelming diction forcing the 
public conscience to the only sensible remedy — the 
banishing of them altogether from the face of the earth. 



ESSAY. 



BY H. G. WETHERILL, M. D., TRENTON, N. J. 



Salpingitis and Pelvic Adhesions. 

The etiology of disease is always important. The 
course and consequences are then more easily traced and 
the treatment is more rational, and may be carried out 
with better chances of success, and best of all, it ofifers an 
opportunity for the use of preventive measures. 

This is a day of quarantines and preventive medicine, 
and whenever these principles can be brought to bear 
against any pathological condition, they may be expected 
to reduce the suffering, invalidism and mortality from 
that disease. 

Infectious, contagious and septic diseases are now be- 
lieved to constitute a very large proportion of the mala- 
dies of mankind. The acceptance of this viev/, carries 
with it so much responsibility to the medical attendant 
or surgeon, that we must learn to exercise great care that 
we may not be the agents or carriers of disease. We 
must also educate our patients into the adoption of pre- 
ventive means and emphasize the importance of cleanli- 
ness of person, apparel and environment. 

These remarks are intended as an introduction to a 
review of our present opinions as to the origin and treat- 
ment of oophoro-salpingitis. 

The point has been reached when it can be said that 
there is no such thing as primary idiopathic ovaritis. 
Pozzi says: " I do not think there are any cases of ovar- 



I02 MEDICAL SOCIETY OF NEW JERSEY. 

itis, properly so-called, that are not preceded by endome- 
tritis and salpingitis/* and this view is concurred in 
to-day by a large majority of those who are best qualified 
to judge. 

If it be true then, that these tubal and ovarian inflamma- 
tions and suppurations are the results of infection through 
the uterine canal, we must take full cognizance of the 
situation and do all in our power by care of ourselves, 
our instruments, our methods, as well as by advice to 
our patients, to reduce the dreadful consequence of these 
diseases. 

All intrauterine manipulations or operations must be 
aseptic. The uterus and vagina must be maintained in 
a strictly aseptic condition after abortion or labor at 
term, and particularly must this be so if any lacerations 
or abrasions have been made in the mucus membrane. 

Gonorrhoea in women must always be treated with 
this complication in view, and the bride of a man who 
had before marriage a slight, gleety discharge (which may 
have been pronounced non-contagious), must be watched 
when she comes home from the wedding journey, with 
tenderness in the inguinal regions and a more or less pro- 
fuse leucorrhcea. 

We must bear in mind that the peritoneal cavity is 
the only serous cavity having an opening externally, and 
that these openings lead out through a canal which is 
rarely clean in a surgical sense. We should instruct our 
patients that the vagina must be kept clean. 

Fifty years ago (1843) ^hat excellent physician, that 
poet who is loved and revered by the medical profession 
of this country, as few men have been, Oliver Wendell 
Holmes, demonstrated in a most clear and logical paper, 
the contagiousness of puerperal fever, and insisted upon 
the physician as a factor in its dissemination. Dr. Gor- 



\ 



ESSAY. 103 

don, of Aberdeen, in 1795 published a treatise which 
supported the same views, so we must look upon the 
idea of infection of the peritoneum by the way of the 
vagina, uterus ^and tubes as no new thing. The eight 
conclusions at the end of Dr. Holmes* paper are sound 
and rational, and with slight changes in the phraseology 
to meet the requirements of a nomenchiture bred of a 
better knowledge of bacterology and antisepsis, would 
read well to-day as an ending of any paper upon septic 
peritonitis. He says, in his essay, " I had rather rescue 
one mother from being poisoned by her attendant, than 
claim to have saved forty out of fifty patients to whom 
I had carried the disease." 

Tubal inflammations may be placed in two broad and 
general classes as is done by Pozzi. For the purpose of 
diagnosis and treatment these are the two conditions we 
must consider ; they are cystic and non-cystic salpingitis. 
The non-cystic variety is amenable to treatment which 
would be futile, injurious or highly dangerous in an 
encisted salpingitis, so it is important to make a discrim- 
inating diagnosis at as early a day as possible, and adopt 
a line of treatment adapted to the variety of the disease 
we find. 

The fertility of many women has been sacrificed un- 
necessarily by the removal of apendages, which might 
have been saved if some rational and more conservative 
treatment had been substituted for an oophorectomy, 
which until very lately has been the remedy for all pelvic 
pain or tubal disease, whether it be catarrhal, purulent, 
hemorrhagic or parynchematous, and regardless of its 
being cystic or not. Much may be done for non-cystic 
salpingitis by rest in bed, large hot water douches, dila- 
tion and drainage of the uterine canal, and perhaps curet- 
ting and applying or injecting iodine or carbolic acid or 



104 MEDICAL SOCIETY OF NEW JERSEY. 

other remedies ; and no case must be condemned to an 
oophorectomy till long and faithful trial of these meas- 
ures has been made. 

It has been my good fortune to have just had a case 
in which a large, painful and inflamed tube yielded most 
satisfactorily to this line of treatment, and it is to-day as 
free from pain and fullness as a normal one. Of course, 
it was non-crystic ; but may not a crystic salpingitis be 
opened and drained through the uterine canal? Cer- 
tainly, such a thing is quite possible, but there is always 
the risk of rupture in any other direction with all that 
implies. 

The simplicity of a modern coeliotomy and its low 
mortality with reasonable precautions as to cleanliness 
have evolved many operators, while the great need 
of the day was a supply of discriminating diagnostitions. 

Authors and operators are too apt to dilate upon the 
ease with which a pelvic or abdominal diagnosis may 
be made. As a matter of fact, exact diagnosis of pelvic 
and abdominal conditions is rarely easy, and it is next to 
impossible to tell, before the abdomen is opened what 
complications may be found to make an operation diffi- 
cult. Few men who have seen the work of our most 
dexterous operators and skillful diagnosers, have failed to 
see frequent corrections of diagnosis after the operation 
has begun. This is only what must be expected under 
the circumstances, for the variety of the possible condi- 
tions as they affect a number of possible organs is very 
great. 

In drawing attention to this fact, it is with no desire to 
belittle the work of these men, for it is truly marvelous 
that correct conclusions are so often reached ; but it is 
hoped the broad statements of some enthusiastic and 
able workers may be taken with the grain of salt so 



ESSAY. 105 

necessary to the digestion of their claims to infallibility. 
It is also to be hoped that we may be tolerant of the 
opinions 'of others and most lenient to a fellow who has 
made a mistake in such a case. For each one's day for 
his mistake is sure to come. We must exercise all the 
skill and car^.of which we are possessed, and when one 
does his best, he should enjoy the support of those about 
him. 

A distended and abcessing fallopian tube does not, as 
a rule, present the greatest difficulties in the way of diag- 
nosis. With or without an anaesthetic the tube and ovary 
can usually be brought between the fingers of the oppos- 
ing hands and the outlines traced with reasonable ac- 
curacy. 

The question of treatment then has to be met, and it 
is here we encounter the differences of opinion of the 
advocates of different plans. Just why a collection of 
pus in a fallopian tube should be thought amenable to 
treatment which would not apply to like conditions else- 
where, it is hard to understand. It is also difficult to 
determine why a rule which applies to pus elsewhere 
does not apply to pus in a tube. 

In no other portion of the body is the surgeon given 
the opportunity to remove at once the abscess, its sack, 
and the consequences to adjacent tissues as in pyosalpinx. 

The details of oophorectomy are now so perfected and 
the mortality in the hands of a dexterous operator is so 
low that it seems beyond question the best method of 
dealing with the greater number of these cases. 

That electrolysis is competent to disperse and cure a 
tubal abscess is irrational and incredible. The results of 
its use for this purpose have been in many cases worse 
than simple failure to cure, and much testimony has been 
given of its injurious effects. 



IC6 MEDICAL SOCIETY OF NEW JERSEY. 

Cases may present themselves, in which evacuation 
and drainage of the tube through the.vaginal vault or the 
dilated uterine canal is expedient, but the majority are 
* of a kind that will do best under abdominal sec- 
tion. It is then possible to deal with adhesions and 
other pathological conditions which may present, as well 
as remove in toto, abscess, sack and all. 

Little can be gained and much may be sacrificed in an 
attempt to empty and drain a pus tube through an 
abdominal incision, with the object of saving the appen- 
dage to the woman. 

Functionally the appendage is destroyed, and it should 
not be left to be a possible source of infection and re- 
newed danger at a later day. 

True conservatism does not consist in the preservation 
of organs and tissues with functions destroyed, and with 
the added risk of there being a source of new trouble any 
day. That is most conservative which most completely 
eradicates the disease and leaves the patient most free 
from pain and disability. 

Adhesions are rarely absent in a pelvis that has been a 
domicile for pus tubes. Adhesions are the great bar to 
exact diagnosis. They are the chief element of danger 
during operations, and the denuded surfaces they leave 
(for the formation of new attachments) are responsible 
for most of the pain and discomfort subsequently ; they 
may be a cause of death after all other dangers are past, 
for perforating of the intestine or of some other viscus 
may occur at a spot that has been left thin and weak 
through rupture of its outer coats during their separa- 
tion, or an intestinal obstruction may be caused by the 
compression of bands or the contraction of cicatritation; 
nevertheless, adhesions are conservative in the main, and 
it is only by the aid of this power of the peritoneum to 



ESSAY. 107 

throw a protecting wall about a focus of diseases or sep- 
sis ; by its power to encyst a hemorrhage or an exudate 
that abdominal surgery is ever made necessary, or that 
it has become possible. 

The adhesions are the result of the disease and are 
essentially protective in tendency. They may become a 
source of pain, and the time may come in the history of 
a case when the primary disease has been disposed of 
and the adhesions become the disease ; still, the tendency 
is to absorbtion of adhesions after their usefulness is 
gone. Dr. W. Gill Wylie, in a recent discussion of this 
subject, in New York, stated the facts as follows : ** If 
you cure your diseased organ, your adhesion will disap- 
pear ; its functions will go, and it will disappear and be 
absorbed.** 

Within the last few weeks I have had the opportunity 
to examine two patients, upon whom I did a celiotomy 
for pysoalpinx more than a year ago. One was done 
December, 1891, and the other March, 1892. 

The cases were as like as it is possible for two cases to 
be. Both had the tenderness, pain and the constitutional 
symptoms of the disease. Both were bedfast and so 
seriously ill that recovery was not looked for by the 
friends, and an examination of each revealed a pelvis 
packed with exudate ; the cervix protruded frpm a vaginal 
vault, which was firm and unyielding in all directions, and 
gave one the impression of the pelvis being run full of 
plaster of Paris, which had embeded and fixed the womb 
unmovably. 

Upon operating, this diagnosis was verified : The 
fundus of the uterus was buried in this mass of limph 
and adhesions, and it was with the greatest difficulty 
that the tubes and ovaries could be isolated, tied off and 
removed. The pus sacks were not large (I have seen 



108 MEDICAL SOCIETY OF NEW JERSEY. 

larger ones not nearly so adherent), but there nriust have 
been periodical leakage from them, which nature was 
obliged to meet by a new exudate each time, and so this 
enormous conservative wall was constructed. In the first 
case the mass was so attached to the sigmoid flexure, 
that great rents were made down to the mucus coats of 
the bowels in enucleating. 

In the second, the apendix vermiformis was involved 
in the mass, so that its amputation was necessary to get 
the mass away. 

These patients did reasonabiy well after operation, and 
to-day there is not a band of adhesion that in any way 
annoys either of the patients, or that can be made out 
by examination. 

Let us look back and review the part the adhesions 
played in these two cases. First, they were thrown out 
as a protecting wall about the septic focus in the pelvis, 
and they were renewed to meet each new demand ; sec- 
ond, they were thrown out after the operation about the 
rents and sutures in the sigmoid and the apendix to pre- 
vent foecal extravasation, and third, at the end of a year 
after the removal of the disease, no trace of adhesion re- 
mains to annoy the patient or the physician. 

We could hardly ask a better demonstration of the 
use of adhesions or find better examples of their evolu- 
tion and absorbtion. 

Within the past month I removed by coeliotomy and 
hysterectomy a very large multiple fibriod. A most care- 
ful and dexterous operator attempted its removal a little 
more than three years ago and made an incision down to 
the tumor at least six inches in length ; no vestage of an 
adhesion between the tumor and the cicatrix was to be 
found ; both were perfectly smooth and free from bands 
when I opened the abdomen. The first operator is a 



ESSAY. 109 

man who comes as near doing a perfectly aseptic opera- 
tion as can be done, and I believe the freedom from 
bands was due to this. The traumatism was not of itself 
sufficient to create bands that would endure so long if 
they were ever produced. 

* Dr. Henry C. Coe, in a recent paper, said: " Where 
extensive pseudo membranes have not been separated at 
the time of operation, I concur with Kelterbom in be- 
lieving that the formation of adhesions is to be referred 
to mild septic infection, rather than to traumatism of the 
healthy peritoneum.'* 

We may fairly conclude then : 

First, Tubal and ovarian inflammations are usually as- 
sociated ; the one rarely being present without the other. 

Second. This tubo-ovaritis is nearly always the result of 
the extension of a specific or septic inflammation along 
the mucous membrane or through the lymphatic vessels. 

Third, That this implies an unclean vagina or uterine 
canal (in the modern surgical sense), or that hands or 
instruments introduced into the genital tract have car- 
ried infection to it. 

Fourth, Abrasions and lacerations of the mucous mem- 
brane greatly increase the risk of the tubo-ovaritis by 
lymphatic extension and by the facility offered for the 
growth of bacteria, and the difficulty of sterilizing wounds 
in such a situation. 

Fifth. Surgical cleanliness of all vaginal and uterine 
manipulations is imperative as a prophylactic measure. 
I^abor at term and abortions must be followed by rigid 
antisepsis. Lacerations should be approximated at once 
when possible, and abrasions kept perfectly clean. 



" "The Etiology and Pathology of Pelvic Adhesions." Read before the 
Woman's Hospital Alumni Association, January 17, 1893. 



no MEDICAL SOCIETY OF NEW JERSEY. 

Sixth, Adhesions about an inflamed tube and ovary are 
conservative in design and effect, and should not be dis- 
turbed till the disease back of them is removed. 

Seventh. When the disease is renooved, the adhesions 
tend to absorbtion and usually disappear in time. 

Eighth. Septic infection is a more potent factor in 
causing adhesions than simple aseptic traumatism, and 
the adhesions following slight injury to the healthy 
peritoneum are due to mild septic infection, which may 
have taken place at the same time. 



\ 



ESSAY. 



BY SAMUEL E. ARMSTRONG, M. D., OF RUTHERFORD, N. J 



Some Thoughts on Symptoms and Diagnosis. 

In discussing this subject I wish the term symptom 
to be defined as meaning certain manifestations indicat- 
ing a deviation from the normal health standard ; and 
diagnosis, the conclusion or conclusions derived from the 
symptoms. 

I am well aware that the diagnosis does not always 
hing« on the symptoms alone, as the questions regarding 
heredity, personal history, exposure, prevalence of disease, 
former attacks, etc., are usupilly taken into account. The 
diagnosis is the only direct and legitimate outcome of the 
symptoms, as out of it, and not the symptoms, we form 
our prognosis and construct our plan of treatment. 
Pathological conditions are, to be sure, sometimes indi- 
cated by the symptoms; however, we gain our best and 
most reliable information regarding morbid changes from 
post-mortem rooms and the pathological laboratory. 

I shall endeavor to keep myself within the proper 
bounds of my subject. However, in order to make my 
meaning clear, it will be necessary for me to go outside of 
them at times, as, for example, there is a perfect sequence 
from pathological conditions to symptoms ; therefore, 
you will allow me to classify my subject somewhat as 
follows : 



112 MEDICAL SOCIETY OF NEW JERSEY. 

1st. From pathological changes to symptoms, to 
diagnosis, to treatment. 

2d. From functional disturbances to symptoms, to 
diagnosis, to treatment. 

3d. From a lying and deceitful patient, a perfectly 
normal body, to an absence of rational symptoms, to a 
diagnosis, to treatment. 

4th. Anomalous cases. 

Success in all these various classes depends on a 
proper understanding of the symptoms — or a realization 
that none exist — and, in consequence of the knowledge, 
a correct diagnosis, and how necessary is it that the 
physician should be able to grasp the situation. It is 
said of poets that they are born, not made. I believe 
that the- same thing is, in a large measure, true of diag- 
nosticians. However, education of the right kind can be 
made to be a powerful factor in the completion of the 
work which nature has already begun ; and to this 
end, I believe that a correct curriculum, not only in the 
medical college, but in the preparatory education of the 
physician, is necessary. One of my old teachers when 
called upon to write his autograph for his pupils almost 
invariably wrote this sentiment, viz.: " Learn to think," 
and then signed his name. This is laconic — expresses 
much, but not enough. The medical student should not 
only be taught to think, but he should be taught close 
observation, the analysis and synthesis of thought and the 
proper application of his conclusions, and, to these ends, 
I believe that there are no branches of study better cal- 
culated to develop his mind than botany, logic, psy- 
chology or mental philosophy and the higher mathe- 
matics. Botany is a useful science to the physician be- 
sides teaching him close observation ; logic teaches a 
proper order or sequence in thought ; psychology or 



ESSAY. 113 

mental philosophy trains the understanding and teaches 
us to know the mind, while the higher mathematics tend 
to train the reasoning powers to a remarkable degree and 
teach us application of thought ; and, I say, all of these 
attributes of mind are necessary to the successful diag- 
nosis of the cases which we meet. However, I would not 
wish to be understood as saying that he who possesses 
them all will never fail, for ofttimes symptoms are obscure, 
perplexing and misleading. I remember an instance of 
this which occurred during my college career. One of 
our professors, a man of great ability, did an operation 
for hydrocele and found tubercular disease. I have heard 
it related of a noted professor and author that he could 
not tell what was the matter with his patient, even after 
death and by the aid of a post-mortem examination, and 
that he threw his dissecting knife down in utter disgust. 
Ah, is it not a pity that man*s wisdom is finite ? 

However, let us return to our classification and take 
up class 1st, /. ^., from pathological conditions, to symp- 
toms, to diagnosis, to treatment. 

It may be laid down, as a rule, with perhaps a few ex- 
ceptions, that real and definite pathological conditions 
produce real and definite symptoms, and in such cases a 
definite diagnosis can be determined upon and a definite 
form of treatment, such as our knowledge of the thera- 
peutics of the disease at the present day affords, selected. 
Take, for example, a case of croupous pneumonia. We 
know that in this disease there is, in its early stages, con- 
solidation of a certain portion or portions of one or both 
lungs, and that this pathological condition produces rusty 
sputa, dullness or purcussion, crepitant rals and bronchial 
breathing. In the typical case the diagnosis of pneu- 
monia is not difficult. But there is a class of cases which 
are not so easily diagnosed. I refer to those in which 



114 MEDICAL SOCIETY OF NEW JERSEY. 

there is but little consolidation of lung tissue and that 
lying deep and far removed from a large bronchus and 
emiting no characteristic physical signs or rusty sputa. 
In these cases we can usually reach a satisfactory result 
by exclusion, the appearance of the face, the initial chill 
or chilliness occurring but once, .or lasting through a part 
of a day only, the character of the fever usually taking a 
low range, and the persistant vomiting which I regard as 
one of the most trustworthy of all the symptoms in this 
class of cases of pneumonia. The thermometer is the 
only instrument of precision which we possess that is of 
any use in the diagnosis of pneumonia. The stethoscope 
may be prized by some, but for my part, I prefer the 
naked ear applied to the chest well. I have recently had 
a case of this disease which presents some points of inter- 
est. On April 2^1 was called to see P. M., a boy aged 
nine years. The symptoms, with slight variations, were 
such as I have described, the vomiting being quite per- 
sistent. However, on the fourth day, rusty sputa ap- 
peared, and there was dullness and the other character- 
istic symptoms at the apex of the right lung and consid- 
erable pain. The case went on with the usual symptoms 
to about the tenth day, when there seemed to be an at- 
tempt at crisis, but from this time on there was constant 
fever, loss of flesh, and while the physical signs at the 
apex were clearing up there was increasing dullness at the 
base. There was bulging of the intercostal spaces, no chills 
or vomiting. It was evident that there was now a fluid of 
some sort in the right chest cavity and, hoping that it 
was a serous affusion, 1 adopted the expectant plan and 
waited for nature to produce resolution. On the 28th of 
May I felt that all was going well with my little patient, 
and that in all probability in one week he would be quite 
well again, but when I saw him again on the 4th of June 



ESSAY. 115 

it was evident that nature would not do what I had so 
fondly hoped she would, and art must step in and give 
her all possible aid. Accordingly, on the 6th, I asked 
Dr. Tygert to assist me in aspirating the chest. Before in- 
troducing the large needle, ** in order to make assurance 
doubly sure,'* I introduced the hypodermic needle and 
drew ofif a few minims of fluid, to be sure, but it was pus ; 
the large needle was introduced with poor success. An- 
ticipating this condition I had previously told the father 
that in case pus were found, it would be necessary to re- 
sect a rib, and with the assistance of Dr. Tygert and his 
nephew, Mr. Win. Tygert, a medical student, on June 7 
I did this operation with the usual success. 

The point of practical interest in this case and the one 
on which I wish to offer comment, is the use of the 
hypodermic syringe as an instrument of precision ; it is 
invaluable. One could be sure without it that there was 
fluid in this chest, and, on account of the continued fever 
and the marked emaciation, one could suspect that it was' 
pus ; but the hypodermic syringe settled it beyond 
doubt. However, as good an instrument as it is, it does 
not tell everything, notably the amount of fluid. In his 
Shattuck lecture on tuberculous pleurisy delivered June 
13, present month, at the meeting of the Massachusetts 
Medical Society held in Boston on that and the follow- 
ing day, and which I had the honor of attending as your 
delegate, Prof. Osier, of Johns Hopkins, related a case 
which came under his observation, in which three ribs 
Were resected with the result of finding about a tablespoon- 
full of encapsulated pus at each resection. I should 
think that, in a case of this kind, the physical signs would 
be a much more reliable guide to surgical interference or 
not, than exploratory puncture, although, as I remember 
the discourse, Dr. Osier did not state on what basis the 



Il6 MEDICAL SOCIETY OF NEW JERSEY. 

diagnosis was made. I sincerely hope that we may all 
have the privilege of seeing this lecture in print, as it 
was a most admirable production. 

We will now take up class 2nd, i. e.y from functional 
disturbances, to symptoms, to diagnosis, to treatment. 

That class of diseases known as functional is very 
rapidly disappearing from our nomenclature, and the 
sooner we discard the idea that it is possible for any 
organ to be disturbed in its function without adequate 
cause, the better it will be for all concerned. I cannot 
conceive it as being possible that there are functional 
heart murmurs without a pathological change of some 
sort ; it may be in the blood, in the heart muscle, coats 
of the arteries, the endocardium, or the delicate nerve 
balance which controls the heart action may be ** out of 
gear,** which I believe is very often the case in these con- 
ditions of function murmurs and palpitation as well. 
We should examine these patients with especial care. 
However, we should not make any statement which 
could alarm the timid, because to most people, the 
idea that they have a heart trouble soon gets to be a per- 
petual nightmare. When we get to understand nerve 
and blood pathology better we will better understand 
derangements of function which are really symptoms, in 
themselves, and not the disease per se, I have recently 
had a case which illustrates my meaning. A short time 
since a young woman called at my office complaining 
that her courses had ceased. I had no trouble in dis- 
covering that she was terribly anaemic and that, in all 
probability, this was the cause of her complaint. A 
course of iron soon brought about complete restoration 
of the function and recovery. 

Class 3d — From a lying and deceitful patient, to a 
perfectly normal body, to an absence of rational symp- 
toms, to diagnosis, to treatment. 



ESSAY. 117 

This class can be subdivided as follows, viz.: sub-class 
A, those who lie with knowledge aforethought, the 
malignerers, pure and simple ; B, those who have some- 
thing which they wish to conceal and propose doing so 
by lying ; C, those who lie innocently, deceiving them- 
selves as well as others. 

How is the malignerer to be met ? In these cases 
there is almost always an absence of objective symptoms 
or such symptoms are simulated, and the greatest 
amount of knowledge and shrewdness is necessary on the 
part of the physician to cope with these persons. One 
case by way of illustration will suffice. During the sec- 
ond year of my experience, Susan, a colored woman, 
called me to attend her. I found mitral insufficiency 
and considerable disturbance of the digestive functions. 
But the old "aunty'* did not seem to think that this 
stirred me to sufficient pity. Accordingly, after I had 
called a few times she produced a tomato can containing 
a peculiar appearing substance which she claimed to have 
passed by rectum. I examined it with care, and told 
her that I thought she might have cancer of the lower 
bowel and suggested an examination of this part of her 
anatomy. She accorded me that privilege ; however, the 
result was negative. Now, as a post-mortem showed, 
this old lady had tried to mislead me and, I grieve to 
say, succeeded somewhat. In these cases there is usually 
an object, which gets to be very apparent. In this one 
just recited the object was a begging one. This good, 
pious old darkey wished to have her coal bin and larder 
constantly well supplied by charitably inclined people, 
and, as I previously hinted, she succeeded somewhat. 

Sub-class B — Those who have something which they 
wish to conceal and propose doing so by lying. 

Here we find the young woman who is in an embar- 



Il8 MEDICAL SOCIETY OF NEW JERSEY. 

rassed condition, and we will pass her by only waiting to 
say that it is best to let time make the diagnosis, pro- 
vided there be any doubt. 

Sub-class C — Those who lie innocently, deceiving them- 
selves as well as others. 

To this class belongs the hypochrondriac and some 
hysterical subjects. In these cases an absence of objec- 
tive symptoms — diagnosis by exclusion — and the pres- 
ence of introspection on the part of the patient, usually 
lead the way to a reliable conclusion. Where introspec- 
tion is a prominent symptom — cerebral disease having 
been excluded — some particular organ, as the kidneys, 
uterus or heart is usually the cause of solicitude, and if 
we can satisfy ourselves that this particular organ is in a 
condition of health, we are perfectly safe in diagnosing 
the case as one of hypochondriasis. A patient I have re- 
cently met presents this symptom to a remarkable degree 
— a constant fear of death due to a supposed heart dis- 
ease, and notwithstanding the fact that every physician 
she has consulted, and, as is usually the case in such 
subjects, she has consulted many, tells her that she has 
no such complaint, she still persists in this constant self- 
examination and constant fear of impending death. 
When calling for my opinion she said : " Doctor, if I had 
heart disease, would you tell me of it? " I replied that 
I surely would, and she asked : " Do you think I could 
stand it? Don't you think it would kill me?" I assured 
her that she could stand anything. However, she is still 
haunted with this belief. Can there be any doubt in a 
case of this kind ? 

Class 4th — Anomalous cases. 

Disease sometimes works in mysterious ways and pre- 
sents odd manifestations. It would almost seem that 
a certain cause should always produce a given effect — 



ESSAY. 1 19 

certain poisons, germs or materius morbi, give certain 
symptoms. This undoubtedly would be true were the 
conditions of climate, hygienic surroundings and body 
always the same ; but we find vast variations in all these, 
hence we frequently meet with atypical cases. The mer- 
est tyro in medicine can diagnose the regular forms, be- 
cause, in most diseases, as pneumonia and the eruptive 
fevers for example, there are certain leading symptoms, 
few in number and easily recognized, which stand out as 
a perfectly clear clinical picture. But, what is to be 
done with a case like the following one, complicated with 
the haemorrhagic diathesis : 

Early in April I was called to see Miss S. T., aged 
seventeen years. The leading symptoms were severe 
chill, followed by high fever, persistent vomiting, pain in 
the lumbar region so severe that nothing but large doses 
of morphia would subdue it, constipation, photophobia 
and suffusion of the eyes, throat a little red and ** thick ** 
but not painful. Positive diagnosis held in abeyance. 
On the second day all of the above symptoms still per- 
sisted. On the third day pain and vomiting somewhat 
subdued, but there was an eythematous rash, not at all 
elevated above the surrounding surface, commencing on 
the face and extending over the upper part of the body; 
also, profuse haemorrhage from the uterus, the blood be- 
ing dark but poorly coagulable, a few petechae and black 
and blue spots on the arms and haemorrhagic extravesa- 
tions under the right conjunctive and under the mucous 
membrane of the uvula, and one in the vale of the palate 
about the size of a double B shot with perfectly regular 
margins, a little longer one way than the other, but clean 
cut. These were the leading symptoms on the evening 
of the third day. On the fourth day there was but little 
pain in the back, the fever took a much lower range — it 



I20 MEDICAL SOCIETY OF NEW JERSEY. 

had been as high as 104 2-5 — there was no more vomit- 
ing, some hebitude of mind but slight delirium, but the 
erythematous rash had extended pretty well over the body, 
near its margins, resembling the rind of pork overscalded 
in the dressing. The petachae were regularly distributed, 
particularly over the face. On the ending of the fifth 
day the patient being perfectly rational, had her last 
talk with her relations and " passed into that bourne 
from whence no traveler ever returns." This was a sad 
case, indeed. Looked at from a scientific standpoint, it 
was an exceedingly interesting case. It was anomalous, 
something out of the usual line, but evidently belonged 
to the group known as the eruptive fevers. Which one 
of this 'group was it ? The leading symptoms were severe 
chill, high fever, persistent vomiting, severe pain in the 
lumbar region, petechial emption, and a haemorrhage un- 
der the conjunctivae. Could it have been anything less 
than small-pox ? This was the diagnosis : petechial small- 
pox. This opinion is greatly strengthened when we 
know that the patient was exposed to the disease fifteen 
days before the initial chill — she was really feeling poorly 
two days before this time. It is also strengthened when 
we know that soon after S. T. was taken ill, a little next- 
door neighbor was seized with undoubted varioloid. 
These two cases were the origin, the alpha and the omega, 
of the ** small-pox scare " which we had in Rutherford 
during the month of April last. 

But one more word in conclusion. The correct diag- 
nosis of disease depends, not only on symptoms, family 
or personal history, exposure or previous attacks, but on 
the physical and mental condition, education and natural 
ability of the diagnostitian, as well. A man who is 
physically and mentally exhausted from overwork can 
not do himself justice in this field, to say nothing of his 



ESSAY. 121 

patients. The best interests of all concerned demand that 
he should take a rest ! Natural ability is a gift from 
God. However, we, as veterans in the field, should not 
lend our aid to young men possessing but little or no 
natural ability, nor should we aid anyone who is not 
willing to thoroughly prepare himself before entering 
upon his medical studies. The fittest should survive. 



ESSAY. 



BY H. G. WETHERILL, M. D., TRENTON, N. J. 



Supra- Vaginal Hysterectomy for Fibroid. 

This operation is not a rare one in the great medical 
centres of this country, but it is always an interesting 
one, and each case has features of its own which make it 
of value to those who may wish to study the results of 
various methods of operating, or the phases of the 
disease. 

There are ways of treating a pedicle that seem to me 
preferable to the extraperitoneal one adopted for this 
case ; and, with a short pedicle like this one, the opera- 
tion of ligating the broad ligaments and uterine arteries 
with the peritoneal flaps drawn over the stump (as is 
done by Baer) is quite as easy of execution, and gives 
infinitely better results, if the mortality does not prove 
to be too great. 

I was most anxious to have this patient recover, and 
naturally adopted the plan which, up to date, has proved 
most successful from the mortality standpoint. 

I hope and believe the newer method is capable of 
making a record as good, or better, than the old, for it is 
better surgery and more satisfactory from every point 
of view. 

M. J. T., (colored), age 38. 

First noticed tumor thirte^jn or fourteen years ago. 
Has had no bleeding at periods ; flows five or six days. 
Has had intense pain in the small of her back and in- 



124 MEDICAL SOCIETY OF NEW JERSEY. 

guinal regions. Has had asthma since she was fourteen 
years old, with more or less cough at all times. The 
abdomen is very much distended by a hard nodular 
mass, which also extends into the pelvis and nearly fills 
it. This tumor is connected with the uterus, and gives 
one the impression that the uterus is lost in the growth. 
By my advice she consented to an operation, and one of 
the most skillful abdominal surgeons of Philadelphia 
agreed to operate on her. November 23, 1889, ^^ came 
to Trenton with two assistants. Chloroform was admin- 
istered, and an incision made through the abdominal wall. 
A large amount of ascitic fluid escaped. The tumor was 
carefully examined through this incision, and it was con- 
cluded that the growth could not be removed. Adhe- 
sions were said to exist between the tumor and the liver, 
and the tumor and the colon, which could not be separ- 
ated without the greatest danger. The incision was 
closed and the patient made an uneventful recovery. 

Since this operation the patient has been kept on full 
doses of iodide of potash and sulphate of magnesia. 
The tumor has increased in size and the pains have in- 
creased in intensity, so that they are no longer bearable. 
The asthma has been greatly improved by the iodide, so 
that she rarely has an attack, and has little cough in the 
interval. She is desirous that a new attempt shall be 
made to remove the growth, and is fully aware of the 
great danger of such a procedure. 

At my request she was admitted to St. Francis* Hospi- 
tal and prepared for operation. 

JUNE 3, 1893. — OPERATION. 

Assisted by Doctors Cantwell, MacKinsie, McGilHard 
and Norton, and in the presence of the staff, the abdo- 
men was opened through the old cicatrix. The incision 



ESSAY. 125 

was extended three inches above the umbilicus, when, 
without difficulty, a nodular and multiple fibroid was 
easily turned out. There were no adhesions along the 
line of the old incision, and the sole difficulty in complet- 
ing the operation was in making a pedicle. The elastic 
ligature was crowded well down on to the body of the 
uterus, and the pins introduced above it. The tumor 
was then amputated, and the stump reduced in size as 
much as possible by the removal of nodules and trimming 
of the edges. There was a single loop of intestine (sig- 
moid flexure) attached to the left side of the uterus, but 
it was well below the position of the pins and wire and 
was not detached. Hemorrhage of the stump was en- 
tirely controlled by the elastic ligature and subsequently 
by the serre-noeud. The incision was closed in the usual 
way and the wound dressed with iodoform, bi-chloride 
gauze and boracic acid. The pedicle was so exceedingly 
short that for thirty-six hours the patient suffered excru- 
ciating pain in the back, and required liberal hypoder- 
mics of morphia for its relief. Pulse for the first two 
days was about 80 and the temperature about 102. 

Report of Pathologist. 

Horace G. Wetherill, M. D.: 

Dear Sir — I submit the following as my examination of tumor re- 
moved by you. Microscopically it was found to consist of one large 
mass nine inches in length by seven inches in breadth, with distinct 
capsule showing prominent blood vessels upon its surface, with small 
nodules studded over it ; also two (2) large lobulated masses com- 
prised of small nodules. Surrounding these are five (5) distinct nod- 
ular masses about the size of one's fist, with two (2) smaller ones ; 
also about base of pedicle, numerous small masses, size of birds' t,%g. 
One pediculated fibroid polyp, one inch in diameter, dangled from the 
fundus of the uterine canal about midway between the cornua. On 
section was firm and tough, grating under knife, having a glistening 
look; weight 14^ pounds. 



126 MEDICAL SOCIETY OF NEW JERSEY. 

Microscopically : The appearance is that of fibrous tissue containing 
connective tissue cells, few blood vessels, fibres having no special 
arrangement in bundles. 

Diagnosis : Hard Fibroma. 

I. M. SHEPHERD, A. M., M. D. 

June 6. The patient is very comfortable to-day. Has 
little pain ; passed her urine, and her bowels have moved 
in response to salines, castor oil and turpentine ; temper- 
ature 103 2-5. Is bright, chatty and hopeful ; has taken 
a little beef tea to-day. 

June 10. Is still doing well. This is the eighth day. 
Had asthma for twenty-four hours, and is still breathing 
with difficulty ; pedicle is without odor ; one or two 
stitches have abscessed. 

June 24. It is three weeks to-day since operation. 
The pedicle came off with a little aid on the 20th of 
June (seventeen days after operation), and the sinus is 
granulating and closing rapidly. It is about five inches 
deep. Was filled with foul pus from pedicle, but is now 
clean. She had high temperature and pulse just before 
and after separation of the pedicle, due to absorption and 
sepsis. Now, has nearly normal pulse and temperature, 
is bright and well and free from pain. Sat up in a chair 
for one hour to-day. Has taken no morphia for four 
days, i-ioo grains of strychnia sulphate being substituted 
night and morning ; whole line of incision sound and free 
from any hernia. Sinus now one inch in diameter 
at skin. Wound closed with broad bands of adhesive 
plaster, which had shoe-hooks placed at the end, with an 
elastic corset lacing put about them and over the dressing. 

This case is instructive in many ways. It shows : 

First. The unstable character of adhesions inside the 
peritoneum, for there were none found even under the 
scar of the old incision. 



ESSAY. 127 

Second, The value of rigid antisepsis, for there must 
have been fever and adhesions had not the first operation 
been strictly clean. 

Third The chronic course of these sub-serous and 
pedunculated fibroid growth. Their slow growth, and 

Fourth. The freedom from uterine hemorrhage that 
often characterizes them even when a sub-mucus polyp is 
present. 

Fifth. The safety of removal under favorable circum- 
stances, and 

Sixth. The undoubted justification of the surgeon in 
making the attempt, when continued pain and discomfort 
make life a burden, and the consent of the patient is 
secured after a fair statement of the chances for recovery. 

Seventh. The sound cicatrix and freedom from hernia, 
which may be secured with care in suturing the linea alba 
with a stout buried suture, and a close approximation of 
the parietal peritoneum to the pedicle. 

Eighth. The possibility of sepsis from the absorption 
of pus from the gutter about the pedicle, where the com- 
ing off of the pedicle is delayed and sloughing and sup- 
puration takes pl.ace. 



ESSAY. 



BY JOSEPH WILLIAM STICKLER, M. D., ORANGE, N. J. 



Bovine Tuberculosis — Its Transmission to Man 

AND How TO Prevent It. 

The histology of tubercles as found in the bovine 
species does not diflfer, so far as I can learn, from that of 
tubercles found in man. The bovine tribe is pre-emi- 
nently disposed — equally so with man. No predisposing 
cause exercises such a potent influence in the production 
of tubercles as heredity ; from sire to son, from dam to 
offspring, from generation to generation, often in un- 
broken succession, the fatal tendency is transmitted. 
Breeding in-and-in predisposes. Alderneys, Guernseys 
and short horns are specially prone to the disease in 
Scotland. Jerseys, in our country. Early, late and over- 
breeding predisposes. Animals with light barrels, narrow 
chests and disproportionately long legs are more apt to 
have tuberculosis than those perfectly formed. Climate 
and locality exercise a decided influence in the production 
of tubercles. Debility is another predisposing cause. 

Tubercular lesions are developed to a great extent upon 
the serous membranes. The serous layer of the pericar- 
dium, the pleura, the peritoneum and the meninges of 
the brain and cord are frequently affected, and the 



130 MEDICAL SOCIETY OF NEW JERSEY. 

process in these structures may be primary, secondary or 
infective. Seen early, intense capillary congestion is 
noticed, followed very soon by the formation of innumer- 
able villous-like processes, giving the membrane the 
appearance of red velvet. After a time the vascularity 
of these processes disappears and they become converted 
into small hard globular nodules, the color of connective 
tissue. They may remain discrete, or they may become 
connected and form the so-called ** grapes of England," 
or they may form immense masses. Tubercularization 
of serous membranes is accompanied with effusion into 
the cavities thev line. 

Tubercle in the lungs is, next to tubercle in serous 
membranes, the most common form of the disease. The 
first thing noticed post-mortem is miliary tubercles about 
the size of a pin's head, firm, yellowish white and opaque. 
They may be upon the lung surface or in the lung tissue. 
Later, these tubercles become cheesy and partly calcified. 
They may become confluent and form large masses which 
may also become cheesy and calcified. There is usually 
bronchitis with abundant secretion. This plugs the 
smaller air tubes and causes pulmonary collapse in parts 
to which these tubes lead. The connective tissue between 
the lobules, around the tubercles and air tubes, becomes 
thickened and indurated. There are adhesions of the 
lungs to the ribs and diaphragm. The bronchial glands 
are usually involved. The air tubes, large and small, 
stand out prominently upon the cut surface. When the 
udder is tuberculous it is uniformly swollen and quite 
firm. It is painless. The swelling sometimes attacks 
but one quarter, more rarely, two, these being usually the 
hind quarters. Large yellow, cheesy particles, containing 
many bacilli are found in the larger milk ducts. Later, 
large nodules can be felt in the udder. They undergo 



ESSAY. 1 3 I 

the changes to which tubercles are liable. The udder 
may weigh forty pounds. The milk becomes thin and 
watery and contains many tubercle bacilli. 

Symptoms. — The very early stage of the disease gener- 
ally passes unrecognized. When it has made some 
progress the affected animal will isolate itself from the 
rest of the herd after a very wet or cold day or frosty 
night, and will have arched back and erect coat. It will 
move stifly and unwillingly and will cough. The cough 
may be prolonged, convulsive and very troublesome as 
the disease advances; pressure . over the ribs or back 
may cause pain ; appetite indifferent and bowels 
irregular; breathing labored if much lung tissue be 
involved ; discharge from nostrils rare ; pulse quickened, 
otherwise unaltered. The skin becomes harsh to the 
touch, and more tightly adherent to the ribs. If the 
animal be a milch cow, milk, although thin in quality and 
reduced in quantity, may be secreted. The cough in- 
creases. Emaciation, when it begins, rapidly progresses. 
In the last stages diarrhoea is constant ; the foeces have a 
leaden appearance ; the eyes become sunken, mucous 
membranes pale, the hair falls off, the breath is fetid and 
local dropsies make their appearance. Dr. E. F. Brush 
says : " The prominent sign of tuberculosis in the cow 
is an enlargement of the inguinal gland.'* He has never 
seen a tubercular cow without such glandular enlargement. 

Physical exploration of the chest early in the disease 
will reveal a rasping sound and a non-resonant patch. 
As the disease advances, pleuritic friction and moist rales 
may be heard ; still later there will be increased dullness 
over consolidated areas, cavernous breathing and hyper- 
resonance over empty cavities ; at certain points, bronchial 
breathing and whistling sounds. Sometimes collapse of 
the walls of the chest is observed. 



132 MEDICAL SOCIETY OF NEW JERSEY. 

The query, Are human and bovine tuberculosis identi- 
cal ? now presents itself. In answering this question I 
will say that when the lower animals are inocculated with 

. tuberculous matter from man, the results are the same as 
when the tubercular virus of other animals is used, and 
in each case the tubercle bacilli are found. Anatomically^ 
bovine tuberculosis is a progressively advancing affection 
in which nodes and nodules are formed. They may be 
single, or aggregated into masses as large as a potato. 
They are often pedunculated in the serous membranes. 
Calcification is more common than caseation. Gerlach 
fed and inocculated rabbits and goats with matter from 
such nodules and obtained results which led him to assert 
that the disease is transmissible to other animals, and is 
identical with human tuberculosis. Creighton, Orth, 
Bollinger, Klebs, Baumgarten and Cheveau support this 
statement. Koch's discovery of the specific bacillus in 
the pearly nodules appears to remove all doubt upon this 
point. 

Can bovine tuberculosis be regarded as contagious? 
Lydtin states positively that the virus may be taken into 
the lungs through the inspired air, or into the digestive 
system with the food and water. Bollinger produced 
tuberculosis in pigs by feeding them a long time on milk 
from tuberculous cows. In the winter of 1885-6 an out- 
break of tuberculosis occurred in a herd of fifty-one 
animals on the State College Farm, at Orono, Maine. 
One cow was attacked with a husky voice which increased 
in severity ; she was killed the last of January, when her 
lungs were found to be badly diseased. About the same 

* time three others were affected with slight, husky cough, 
and, by the end of February, most of the animals in the 
herd commenced coughing, almost simultaneously. Drs. 
Michener and Bailey discovered that nearly all the 



ESSAY. 133 

animals had tuberculosis. By order of the Cattle Com- 
missioners, the entire herd was slaughtered and buried. 
The history of this outbreak proves conclusively that 
tuberculosis is contagious. 

In the light of our present knowledge it is not neces- 
sary to ask whether human tuberculosis is communicable 
to the lower animals — we know it is. The question, Is 
bovine tuberculosis communicable to man? may, I think, 
be satisfactorily answered in the affirmative. Klebs, 
Bollinger, Stein, Johns, Bang, Toussaint, Cheveau and 
many others besides Koch concur in stating that if milk 
from cattle with tuberculous udders be given for a length- 
ened period, tuberculosis will be developed. 

The following abbreviated letter, given in Bulletin No. 
8, of Hatch Experiment Station, speaks for itself: "An 
infant, a girl about three years old, and a boy aged nine 
drank milk from a tuberculous cow. The cow died May 
30, 1878. In August, 1879, the baby sickened and died 
in about seven weeks. The post-mortem showed 
tubercles in the lungs and cerebral meninges. In 1881, 
the girl died of tuberculosis; in 1886, the same disease 
killed the boy." 

Dr. Anderson, of Seeland, reported a case of a calf 
which received tuberculosis from the milk of a cow with 
the disease in the udder. The wife of the owner, previ- 
ously healthy, soon developed a cough with other 
symptoms of the disease. Her child, born before the 
appearance of the disease, was fed with milk from the 
tuberculous cow and died with the disease within six 
months. Dr. Anderson believed the mother and child 
contracted the disease from the cow's milk. Prof. 
Thomas Walley, of the Royal Dick's Veterinary College, 
Edinburgh, Scotland, wrote me in relation to this point, 
as follows: 



134 MEDICAL SOCIETY OF NEW JERSEY. 

Dear Dr. Stickler : 

I am in receipt of yours of the 7th inst., in reference to the rela- 
tion of bovine to human tuberculosis. Personally, I have no hesitation 
in saying that if there is any one fact more firmly established than 
another, it is the inter-transmissibility and identity of bovine and human 
tuberculosis. It is, of course, impossible to obtain evidence of trans- 
mission from the bovine to the human by intentional and direct 
experiment, but num.erous cases occur of local inoculation in the skin 
of the hand of man during the dissection of tuberculous carcasses, or 
during the act of dressing the same. I am, myself, an example of this, 
as I have been inoculated on three several occasions, and some years 
ago (twenty) I lost a child from intestinal tuberculosis, in which all the 
evidence went to show that it had been induced by milk from a 
tuberculous cow. Direct evidence of transmission of human tubercu- 
losis to animals exists in abundance and so recently as March of last 
year, a translation from the Deutsche Zeitschrift fur Thier-Medicin^ 
for December, 1 889, appears in the Journal of Cotnfiaraitve Path- 
ology, showing that the muscle juice of a tuberculous man is infective in 
the guinea pig, and it is well known that this animal is readily 
infected with bovine tuberculosis. 

I do not think that there is, at the present moment, one Patholo- 
gist of any note in Europe who denies the identity of human and 
bovine tuberculosis. It was accepted at the Hygienic Congress, in 
London, the other day, as an established fact, and, so far as I can 
gather, ?t the Paris Congress, also. I may observe that recently some 
doubt has been thrown on the identity of avian with human tubercu- 
losis by M. Vignal and others, but, curiously enough, these observers 
are agreed that the bacilli in each case have the same origin. 

Dr. J. C. Corlies, in writing to me concerning the same 

matter, says : 

Dr. Stickler: 

Dear Sir : It is considered among the ablest veterinarians that 
bovine tuberculosis is identical with that infecting the human family. 
This conclusion has been arrived at after a careful investigation 
by experts. 

There are two questions of great importance which 
now present themselves for our most thoughtful and 
careful consideration. 



ESSAY. 135 

First. What means shall we adopt to prevent the 
transmission of tuberculosis of the bovine species to the 
human family? 

Second. What steps shall be taken to prevent the 
spread of bovine tuberculosis ? 

In relation to the query, How may we prevent the 
transmission of bovine tuberculosis to man ? let me cite 
a communication from M. Nocard, member of the 
French Academy of Medicine : 

When tuberculosis is ascertained in animals of the bovine species 
the Prefect makes provision for putting them in charge of the veterin- 
ary sanitarians. Every animal recognized as tubercular is isolated and 
sequestered. The animal cannot be taken away except to be killed. 
The killing takes place under the surveillance of the Veterinar}' Sani- 
tarian, who makes the autopsy of the animal and sends to the Prefect 
the verbal report of the examination within five days following the 
killing. 

The viands coming from tuberculous animals are excluded from 
consumption : First, if the lesions are general, /'. ^., not confined 
exclusively to the viscera and their lymphatic ganglia ; second, if the 
lesions, although localized, have invaded the greater part of the viscera, 
or if they have left the viscera and appear as an eruption in the skin 
over the walls of the chest or abdominal cavitv. 

These viands, excluded from consumption, just as the tuberculous 
viscera, must not serve as alimentation for animals but must be de- 
stroyed ; the utilization of hides is not permitted, except after disinfec- 
tion ; the sale and use of milk coming from tuberculous cows is 
prohibited ; however, the milk can be utilized in the alimentation of 
animals, after having been boiled. 

Concerning the tuberculosis of men, so far, nothing has been done 
in France to combat it, The public has been made acquainted with 
the danger of tubercular mucus. The hospitals execute well, in 
general, the destruction of the mucus and the disinfection of soiled 
articles. To this extent is limited the struggle against the disease. 

Accept, sir, the expression of my consideration. 

M. NOCARD. 



136 MEDICAL SOCIETY OF NEW JERSEY. 

He also advises veterinarians to use tuberculin for diag- 
nostic purposes. He would have all dairymen use 
tuberculin and eliminate all animals showing a reaction. 
No cows should be used for breeding which cannot stand 
the tuberculin test. 

In relation to this second query I received from Von 
Hebra, of Vienna, Austria, the following letter: 

Dr. J. W. Stickler, Orange, N. J. 

Dear Sir : We are now in Austria in a state of transition in 
respect to the question you asked me, and many others. There is a 
sort of Board of Health to be created, a central station for investiga- 
tion of food, etc., after which experience our laws are to be altered. 
For this present moment, they do not take special measures to prevent 
transmission of tuberculosis from cattle to the human being. Our 
laws simply forbid the sale of milk of cows suspected of having what 
our veterinary men call perlkrankheit. Every owner of cattle has to 
notify the district veterinarian as soon as he thinks that his cows are 
diseased and, after inspection, they are killed if found to be affected. 
When the owner does not follow the law's command he can be 
punished severely. 

Putting myself at your* further disposal, I am, dear sir. 

Yours truly, 

HEBRA. 

Prof. Walley, of Edinburgh, says: "In reference to 
the methods to be adopted for the prevention of the 
transmission of bovine tuberculosis to the human subject, 
I think they are simple enough and may be summed up in 
three sentences : 

'' I. Kill all tuberculous cattle, i, e., those in which 
the existence of the disease in their systems can be 
diagnosed, and destroy their carcasses and organs. 

'* 2. Prevent the use of milk from animals in whose 
system it can be shown that tubercle exists, or the 
existence of which is even suspected. 

** 3. Prohibit the use (for human food) of the flesh of 
tuberculous animals." 



ESSAY. 137 

Dr. Samuel P. Duflfield, of Detroit, Mich., informs me 
that under their law, ** the milk inspector has a right to 
examine any dairy, and when he finds a cow in poor 
condition, or at all feverish, to take her temperature per 
rectum, and if the temperature is abnormal a veterinary 
is sent there and the owner is notified to separate the 
cow from the herd, and told that any attempt to use 
milk from such a cow will result in our stopping the sale 
of all his milk. I had the city appropriate $500 a year 
for veterinary fees for examining sick cattle ; in this way 
I have control. 

" I hope you will agitate this question for your State, 
so that I may point my Board to what is being done 
elsewhere.'* 

It is apparent that the measures above recommended 
for the prevention of the transmission of bovine tubercu- 
losis to man will prevent its spread among cattle. In this 
manner the third query is answered : 

Lincoln, Neb., May 23, 1892. 
Dr. J. W. Stickler, 153 Centre St., Orange, N. J. 

My Dear Doctor : Your esteemed and most flattering letter at 
hand, and I wish I were able to fulfill the very high opinion therein 
expressed regarding my poor abilities. Still I thank you, for in the 
face of the very bitter opposition my work has received in certain 
quarters in this country, it is encouraging to one's energies to receive 
such kind words of acknowledgment. Let me say that the medical 
profession of this country has always treated me in a most kind and 
encouraging manner, in striking contrast to a large part of the veterin- 
ary. I regret that I am so pressed with work that I cannot, perhaps, 
write you as detailed a letter as the subject suggested demands, and 
far more attend the meeting of your State Society, which would afford 
me intense pleasure as well as needed recreation, as I have many 
esteemed friends in the profession in New Jersey. 

Now regarding the reiattoft of Bovine Tuberculosis to Public 
Health, that, like all such questions, has two sides: ' ist, the just pro- 
tection of the public health. 2d, the just protection of the owner of 
cattle. 



138 MEDICAL SOCIETY OF NEW JERSEY. 

We must not let enthusiasm in all matters of public health run 
away with us and treat the owners of meat or food-producing animals 
unjustly, as I am inclined to think is too apt to be the case in many 
instances. Let me say in beginning, as it is of striking value, that we 
have, as yet, comparatively little tuberculosis in the prairie-fed non- 
housed cattle on the high plateaus of the West. We have some in the 
town cows yielding milk, and almost invariably in Jerseys or grade 
Jerseys. The common cattle are very free from it, even in the towns. 
There is no such close stabling here as in the East ; in fact, you would 
think, and I think, their exposure in open sheds or poor ones, is very 
cruel in winter, but that they are not crowded together and have 
hurricanes of cold and sleet blowing through the stables or sheds, and 
while in winter they become distressingly poor, still as tuberculosis 
is so very rare, is a lesson not to be neglected. 

The question of tuberculosis in cattle must again be considered 
under two heads : ist, the flesh ; 2d, the milk. 

I must say that regarding the danger of consuming the flesh by 
the public, I think it has been or is likely to be greatly exaggerated, 
especially so far as city consumption is concerned. The danger is 
greater to people living in small country towns, or the poorer classes 
on the outskirts of cities. I do not think there is a particle of danger 
in " dressed " beef sent from Chicago or other western cities, both on 
account of the rarity of the disease in western beef cattle and the 
really good inspection which has been going on for years. If there is 
any danger at all in western beef, it is in the canned beef, and the 
poorer cattle are generally canned ; but I think even that can be said 
to" be next to nil. I truly believe that even small country towns and 
villiages in the vicinity of cities should have but one place where meat 
animals are slaughtered, and that such slaughter should be under the 
inspection of a competent and rigidly honest veterinarian. The real 
danger is in the meat in such places where poorer quality of native 
cows are largely slaughtered, and not western cattle, and the meat 
sold directly there, or to the poorer people in the outskirts of cities. 
Nearly all large cities have, I think, some form of a local slaughter- 
house with an inspector — all should have — and no meat from generally 
diseased animals allowed to be sold ; and no meat from local animals 
sold that was not slaughtered in the local slaughter-house. 

Regarding the degree of danger from meat from tubercular cows, 
knowledge and common sense must rule. I do not think there is any 



ESSAY. 1 39 

danger with a few local centers of tuberculosis in the lungs or liver 
and lymph glands generally free, and the animal in otherwise a fat and 
healthy condition; but with the tuberculosis generally disseminated 
and the animal emaciated, I do, to a much greater degree, and such 
carcasses should be condemned. On the other hand, quite a deal of 
allowance must be made from the fact that all meat is pretty generally 
pretty well cooked among the poorer classes ; only the rich who like 
the best beef and know it are much inclined to eat it quite rare, and 
such beef is, one might say, universally free from dar\ger. We want 
more noise in the daily papers, particularly the cheaper ones and in the 
special papers of the working class (they use more than the better 
fixed classes do) on these questions ; and more particularly need drum- 
ming up on the necessity of cooking meats. You may not agree with 
me, but I have come not to believe in condemning pork for the 
Chinese on the ground that a man who is fool enough to eat uncooked 
pork knowing, as they all ought and must do, the danger of eating 
uncooked pork. Such fools ought to die, and it would be a blessing to 
the world if they all did. 

Now as to Milk. There the danger is infinitely greater, particu- 
larly to the young, but, thankfully, the danger is very materially 
lessened in the mixed milk of the milk man ; and the poor are even 
better protected than the rich. The **one cow's milk " for the babe is 
about the biggest humbug on earth and often is concealed "fire-damp " 
to the child. Mixed milk, even with a tubercular cow or so in a dairy 
herd, is far safer than the " one cow's milk " often is, though inspected 
by a veterinarian, on account of the extreme difficulty of recognizing 
tuberculosis in cattle by any physical examination before it has gotten 
pretty well advanced. I recently came across a terrible case illustra- 
tive of the " one cow tragedy." I will call it : The cow was especially 
purchased to nourish a child ; it was a grade Jersey ; it became ill and 
finally died ; I have never seen such a terrible case of tuberculosis in 
a bovine ; no human case I ever saw in my many years in Virchow's 
laboratory ever presented such an extreme case of diffuse ulceration 
of the intestines, and the other organs were as bad ; and yet those 
parents felt they were safe. They were using the milk of their own 
cow. The result need not be mentioned ; it is self-evident. Many 
such cases of the " one cow " humbug have come to my notice. I do 
not think, in fact I know, that a microscopic examination of the milk 
from the '* one cow " cannot generally be depended on, because few 



140 MEDICAL SOCIETY OF NEW JERSEY. 

of us have time to give the necessary and detailed examination, for a 
week, at least, to such a case. Very few competent practitioners 
could spare the time. The intro-abdominal inoculation of a series of 
rabbits or guinea pigs and examination weekly after a week has 
elapsed, is the only reliable test, and that would scarcely meet the case 
in an emergency ; so that in all such cases physicians should recom- 
mend mixed milkmen's milk and support by cooking or sterilization. 
Even cooked milk is far better and safer than the ** one cow" article. ' 

I am getting to be pretty well convinced of the diagnostic value 
of tuberculin in reference to milch cows, though not yet ready to 
endorse its unconditional reliability. It is a subject' I am too busy to 
touch personally, but, if it proves itself the thing, shall at once take 
measures to h'ave one competent Investigator take charge of its manu- 
facture, and endeavor to introduce it among the milk dairies of this 
City and Omaha, in which, I think, there will be no difficulty. 

Now, my opinion is that the State should provide a laboratory and 
abundant means for this work, either under a Committee of the State 
Medical Society or the Board of Health ; and obtain a very competent 
man to take charge of it with such Veterinary Inspectors as are 
necessary ; and make most extensive diagnosis experiments with tuber- 
culin in dairies where there are known tubercular cows, injecting, also, 
the very healthiest-appearing and slaughtering every one presenting 
the * diagnostic symptom " rise of temperature, paying market price 
for these cattle. If the diagnostic value of tuberculosis becomes 
unequivocally established, then the matter should be plain if not 
easy, though I have not that strong faith in public officials always see- 
ing and doing their duty which more enthusiastic men have. Organ- 
ize your laboratory and working forces ; locate every milk dairy in the 
State ; inject your cows ; number, tag or brand every one giving the 
diagnostic symptom of tuberculosis ; remove it from the dairy, make a 
record of it, instruct the owner, let him fatten it or sell it, but have the 
law so made that on selling he is put under a heavy penalty unless he 
notifies the proper authorities; have such cattle slaughtered in a 
public slaughter-house and the carcass then and there inspected by a 
competent Veterinarian, and then allow the flesh to be used or not, 
according to such defined principles. The owner should receive no 
remuneration from the State in such a case. 
Very respectfully yours, 

FRANK S. BILLINCxS, M. D., Director. 



ESSAY. 141 

Lincoln, Neb., June 5, 1892. 
Dr. J. W. Stickler, 153 Center St., Orange, N. J. 

My Dear Doctor : In the Munchener Medicinisch Wochen- 
serif t, No. 20, March 17, 1892, is an article by Kastner, on the infec- 
tiousness of the muscle-juice of highly infected cattle, which, in 
comparison with a former one from the same author, deserves some 
attention (perhaps). In a former series of experiments with the same 
material, (same Journal, 1889, Nos. 34 and 35) he received negative 
results by injections into abdominal cavity of guinea pigs. At that 
time he says that the tuberculous nodes in the lungs and other organs 
were all calcified ; a rather strong statement, I think, for caseation 
must precede calcification, and many small calcified nodules might 
escape examination unless an almost unprecedented examination was 
made. However, to take the author at his word, the results at that 
time were negative because the nodules were calcified. 

Later, Steinheil repeated the experiment, but with the flesh-juice 
of highly tuberculous beings; the nodules were caseous. (Same 
Journal, 1889, Nos. 40 and 41). 

Results positive, Kastner then resolved to repeat his experiments 
with bovine muscle-juice, but this time selected highly tuberculous 

animals with caseated of calcified nodules. (They must have 

been very acute cases in which the caseated condition alone existed). 
This trial of twelve cases, ten gave positive and two negative results ; 
in the latter, tKe case was not so far advanced that the flesh was 
condemned, while for the other ten it was. Hence his conclusion, 
where nodules are calcified, intro-abdominal injections gives negative 
and the flesh can be sold if the animal is not emaciated ; when case- 
ated, it is dangerous. As intimated, I think the former should be taken, 
" Cumgrano salis giganticus** 

Very truly yours, 

F. S. BILLINGS, M. D. 



ESSAY. 



BY WALTER B. JOHNSON, M. D., PATERSON, N. J. 



Present Status of Legislation for the Preven- 
tion OF Blindness. 

The rapid increase in the proportionate numbers of the 
blind in this country during the last decade being over 
four times greater than the percentage of increase in the 
population, has attracted the attention of ophthalmic 
surgeons and others, to a consideration of the best means 
to prevent the occurrence and spread of the diseases 
which are the prime factors in producing the conditions, 
and to the suggestion and probable enactment of laws 
which will ensure skilled and prompt medical treatment 
in the early stages of the diseases, when an unfavorable 
termination may possibly be averted. 

The prevention of blindness has been written upon and 
discussed in foreign countries, and suggestions have been 
offered and adopted, and laws enacted in England, Ger- 
many, France and Switzerland by Wilde, Fuchs, Mag- 
nus, Adder, Steffan and others. 

In 1881 Dr. C. R. Agnew, in his notes on " Contagious 
Diseases of the Eye in Schools and Asylums,'* suggested 
the possibility of the prevention of blindness by legal 
enactment in the following words : 

** Diseases of the conjunctiva and of the cornea are 
largely the cause of prevailing blindness, and yet they 
belong in a great degree to the class of preventable 
diseases. The fact that they do fall into this class gives 
to the sanitarian and^to the legislator a special oppor- 



144 MEDICAL SOCIETV OF NEW JERSEY. 

tunity and advantage for inquiry, advice and legal enact- 
ment, to limit or prevent their prevalence." 

Dr. Charles J. Kipp, in an essay read at a meeting of 
this Society in 1884, on the ** Prevention and Treatment 
of Purulent Conjunctivitis," from which the following is 
an extract, advocated the placing of the care of such in- 
fectious cases in the hands of the State Board of Health, 
pages 98 and 99, New Jersey State Medical Society 
Report, 1884: 

" In England and other parts of Europe measures look- 
ing to the dissemination among the people of knowledge 
regarding the cause of the ophthalmia of the new-born, 
and the means to be resorted to for its prevention, have 
lately been under discussion in medical societies, and 
steps have been taken to distribute among all classes of 
society cards of instruction, drawn up in the simplest 
possible language. The same might be done here by our 
State Board of Health, which has already done so much 
to enlighten the people with regard to the causes and the 
prevention of disease ; and I have no doubt that if this 
Society should see fit to recommend the publication of a 
circular embodying such information, the State Board 
would gladly do this. Most of the cases of blindness 
from ophthalmia neonatorum which have come under my 
notice were, as I have before remarked, the result of 
neglect on the part of the parents to put the case in the 
hands of a competent physician at the beginning of the 
disease ; and it is therefore reasonable to expect at least 
a reduction in the number of the hopelessly blind in the 
future, if the people are made aware that by early treat- 
ment of the disease the eye can be saved, and that 
neglect will probably result in blindness. 

** I believe it to be the duty of every physician attend- 
ing a case of purulent conjunctivitis to point out to the 



ESSAY. 145 

persons living with the patient the very contagious nature 
of the discharge from the eye, and to warn them not to 
use any of the towels, washbowls and other articles used 
by the patient. Whenever it can done, the patient 
should be isolated, and the nurses attending him should 
not only be compelled to wash their hands thoroughly 
with some disinfectant every time they have dressed the 
eye, but should be prohibited from going into other 
rooms. • 

** On motion, it was resolved that the attention of the 
State Board of Health be called to the contagion of 
ophthalmia which can be guarded against by circulars of 
instruction to families." 

In 1887 Dr. Lucien Howe, of Buffalo, presented some 
notes on the " Increase of Blindness in the.United States/^ 
at the twenty-third annual meeting of the American 
Ophthalmological Society, and suggested that a commit- 
tee be appointed by the society to inv^estigate the sub- 
ject. He demonstrated in his article, by a comparative 
table of the statistics of the census of 1870 and 1880, that 
"While the population had increased 30.09 per cent., the 
number of blind had increased 140.78 per cent. That 
the greatest proportion of blindness is nearest the centre 
of density of population and also nearest that portion of 
the country where immigration would be apt to exercise 
the most influence upon the native population, and that 
blindness in the United States is largely due to contag- 
ious diseases. '* 

Resolutions were adopted by the society which called 
for the appointment of a committee of three, to examine 
further as to the apparent increase in the number of 
blind in the United States, and recommended means for 
its prevention. Doctors Lucien Howe, Swan M. Burnett 
and J. A. Andrews were appointed as this committee. 
10 



146 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Howe, in 1889, also presented at the annual meet- 
ing of the New York Society an article on the " Purulent 
Conjunctivitis of Infants and Blindness in New York 
State," showing that the census of 1870 and 1880 indi- 
cated that the number of blind in the State has increased 
eight times faster than the population, although he ad- 
mitted that the returns were probably more complete in 
1880 than in 1870, while maintaining that the indicated 
per cent, of increase was probably very nearly correct. 

He also, by the careful study of the statistics regarding 
purulent conjunctivitis in infants, showed that nearly 25 
per cent, of all the cases of blindness resulted from this 
disease. 

The method of Crede, which consists in a thorough 
cleansing of the eyes of the infant immediately after 
birth and then applying to them a two per cent, solution 
of nitrate of silver, was recommended to all obstetricians 
as a routine practice in every case. He also suggested 
the following course of action : 

** First, to call the attention of the profession in general 
to the apparent increase of blindness, to the importance 
of ophthalmia in children and to the efficacy of proper 
means of preventing it. Second, to request the exam- 
iners of nurses and midwives, to require of the candidates 
some knowledge of the dangers of ophthalmia of infants 
and an acquaintance with the methods of prophylaxis 
now in use. Third, to instruct our committee on legista- 
tion to formulate and recommend the passage of a law 
by which all midwives in the state shall be obliged to 
report the existence of any case of infant ophthalmia 
within twenty-four hours after its occurrence to the 
family physician, to the district physician, or to some 
legally qualified practitioner." 

By unanimous vote of the New York State Society, 



ESSAY. 147 

these recommendations were finally adopted, and as a 
result of the efforts of the committee on legislation, the 
following law was enacted : 

The People of the State of New York, Represented in Senate and 

Assembly, do enact as follows : 
m Section i. Should any midwife or nurse having charge of an 
infant in this state, notice that one or both eyes of such infant are 
inflamed or reddened at any time within two weeks after its birth, it 
shall be the duty of the midwife or nurse so having charge of such 
infant, to report the fact in writing within six hours, to the health 
officer or some legally qualified practitioner of medicine of the city, 
town or district in which the parents of the infant reside. 

Sec. 2. Any failure to comply with the provisions of this act 
shall be punished by a fine not to exceed one hundred dollars, or 
imprisonment not to exceed six months, or both. 

Sec 3. This act shall take effect on the first of September, 
eighteen hundred and ninety. 

Copies of this law were sent to the physicians of the 
state enclosed with the following letter of explanation : 

183 Delaware avenue. 

Buffalo, N. Y., June 2, 1890. 
Dear Doctor — The Committee of the New York State Medical 
Society for the Prevention of Blindness, enclose to you herewith a 
copy of a law passed by the legislature during its last session. By 
thus calling the attention of certain members of the profession, of 
examiners of midwives and of midwives themselves, to the existence 
of such a law, it is hoped that its purpose may be better fulfilled. 
The committee would urge the desirability of promptly reporting cases 
of its violation to the County District Attorney or other proper legal 
authorities, either directly or through the County Medical Societies. 
And with a view to even more stringent regulations in the future, the 
Chairman of the committee would be obliged for information regard- 
ing any cases of conviction under this law. 

Some of the cases tried under this law failed of con- 
viction in consequence of the word " notice '* in the 
second line of the law, the culprits claiming that they 
did not notice the redness or inflammation. 



148 MEDICAL SOCIETY OF NEW JERSEY. 

The law was supplemented by an act fathered by 
Eldridge T. Gerry, Chapter 325, page 681, volume 11, of 
the laws of the State of New York. The clause in 
reference to the prevention of blindness by suitable 
punishment, reads as follows : " When a midwife, nurse or 
other person having the care of an infant within the a§jp 
of two weeks, neglects or omits to report immediately to 
the health officer or to a legally qualified practitioner 
of medicine of the city, town or place where such child 
is being cared for, ,the fact that one or both eyes of such 
infant are inflamed or reddened whenever such should be 
the case, or who applies any remedy therefore without 
the advice, or except by the direction of such officer or 
physician, the penalties prescribed by the law shall be 
enforced." 

As far as could be ascertained the only action of any 
Boards in this State was taken by the State Board of 
Health in October, 1886, and by the State Board of 
Medical Examiners under an act of the Senate and 
General assembly of the State of New Jersey, entitled, 
"An act to regulate the practice of midwifery in the 
State of New Jersey," approved March 28, 1892. 

This action consisted in placing the following condition 
on the official certificate to midwives : " Fifth condition. 
That you shall secure the . attendance of a reputable 
physician at once, whenever the new-born infant is asphixi- 
ated, is blue, or does not breathe or has any convulsions, 
deformity or malformation, retention of urine or feces, 
bleeding, redness or inflammation of the navel ov any szvell- 
ing, redness or inflammation of, or discharge from the eyelids 
or eyes, or any other abnormal condition." 

The New Jersey State Board of Health have issued 
Circular No. 47, ** Prevention of Serious Injuries to the 
Mind, the Eyes, the Ears," and also refer to the subject 



ESSAY. 149 

of the prevention of blindness in Circular No. 78, ** Pro- 
tection of Schools from Communicable Diseases." In 
Circular 47, the result of neglected eye disease is carefully- 
considered and C. R. Agnew, M. D., of New York exten- 
sively quoted. A very concise and complete set of rules 
credited to Dr. Charles J. Kipp, of Newark, entitled, 
** How to Prevent the Spread of Contagious Diseases of 
the Eye and What to do for Them," is incorporated in 
this circular. 

The following salient points are worthy of special note: 
" Any affection of the eye which gives rise to the form- 
ation of much matter (discharge) may be looked upon as 
contagious. Teachers and persons in charge of asylums, 
schools, etc., should not permit a child with sore eyes to 
attend school or be admitted into an institution contain- 
ing children, unless a competent physician has certified 
that the eye disease is not contagious." 

Regarding, purulent ophthalmii of infants the rule is 
" In all such cases it is the imperative duty of those in 
charge of the infant to see that a competent physician is 
placed in charge of the case, for if properly treated the 
disease will, in all probability, pass away without damage 
to the sight, while if it is neglected, hopeless blindness is 
only too often caused by it." It is said that nearly one- 
half of the inmates of the schools for the blind have lost 
their sight from this disease. 

The circular is very carefully drawn throughout and 
would seem to be applicable to such cases and capable of 
accomplishing all that could be done by circulars alone, 
providing that a very general distribution was made to 
the physician of the State, also to all midwives, nurses 
and any other person having the care of infants who 
might develop the disease. 

In 1890, at the meeting of the American Ophthalmo- 



s 



150 MEDICAL SOCIETY OF NEW JERSEV. 

logical Society, Dr. Howe presented a paper and the 
committee, of which he was Chairman, appointed to 
inquire into the "Causes and Prevention of Blindness,'* 
made a report in which the following recommendations 
tending towards the enactment of laws in all parts of the 
United States, were offered for the consideration of the 
members of the Society : 

^'First. To familiarize the profession with the advan- 
tages of Crede*s method as a means for lessening the 
number of cases of ophthalmia neonatorum. It is a 
lamentable fact that a large portion of physicians in 
active practice, and many obstetricians, are entirely 
ignorant of the advantages of this simple procedure, or, 
for some reason, have neglected to make any systematic 
attempts to test its efficacy. A great deal depends upon 
those whose practice affords them opportunities of seeing 
the dire effects of purulent ophthalmia, for by the pres- 
entation of papers at medical societies, or by discussions 
with persons with whom they come in contact, much 
good work can be done in this respect. 

" Second, It should be the endeavor of those familiar 
with the subject to appeal particularly to the examiners 
of midwives, and, when possible, to midwives themselves, 
in order to impress upon them the dangers of ophthalmia 
neonatorum, or, still better, to encourage the enactment 
of laws in various states which would require nurses to 
promptly report every such case to some legally qualified 
practitioner. The fact that nurses and midwives in most 
states have a very irresponsible position which enables 
them to do much harm ; the fact that a very little negli- 
gence or delay with this class of cases often results most 
disastrously to the patient, and the fact that the duty of 
nurses in this respect in foreign countries has already been 
established, and at least by* one state in the Union, 



ESSAY. I 5 I 

inspires the hope that creditable reformation may take 
place in other parts of our own land. 

"A certain amount of attention paid to these two 
suggestions by a few of the prominent American occu- 
lists might diminish appreciably the baneful results of 
that one disease, ophthalmia neonatorum, which produces 
the largest number of these unfortunate sufferers. 

** Third, The committee would recommend that 
greater care be taken in instructing physicians to 
asylums and residential schools, and other persons having 
charge of such institutions, concerning the dangers of 
contagious ophthalmia in any form. Here, also, it would 
be well to seek the aid of legislation in limiting the number 
of inmates proportionally to the size of the school, to. 
the air space in the dormitories, etc., as has been done 
already in the State of New York. 

'* Fourth. Greater care should be exercised in the 
prevention and intelligent treatment of cases of purulent 
conjunctivitis and other contagious conjunctival diseases 
of adults. In workshops, hotels and other public places, 
where practicable and advisable notices could be posted, 
calling attention to the danger of contagion from roller- 
towels, from imperfectly clean wash-basins, or similar 
sources of contamination. 

^^ Fifth. In order to prevent the introduction of cases 
of trachoma and other forms of contagious eye diseases, 
it is desirable that more stringent regulations be made 
by the commissioners of immigration. Suspicious cases 
should be quarantined, and if there is danger of blind- 
ness to the individual he should be returned to his own 
country. It is certain that a considerable number are 
admitted each year, the condition of whose eyes neces- 
sitates application for public relief, either at the time of 
landing or soon after, and it is very probable that the 



152 MEDICAL SOCIETY OF NEW JERSEY. 

apparent increase of blindness in the United States is 
due, in no small degree, to the number of cases of con- 
tagious eye diseases, more or less developed, that come 
among the immigrants each year and are distributed to 
different parts of the country. 

^'Sixth. As a certain number of cases of very imper- 
fect vision or blindness result directly or indirectly from 
myopia acquired in youth, superintendents or school 
teachers and parents ought to be instructed concerning 
those precautions, which taken early undoubtedly lessen 
the proportion of myopes. This phase of the subject 
has already received considerable attention in certain 
parts of the country and is too familiar to require any 
further mention. 

^'Seventh. As another considerable portion of cases of 
blindness are due to accidents which occur in factories 
and are the artmost inevitable results of the pursuance of 
certain trades, its seems advisable to post notices near 
grindstones, in bottle shops, machine shops and similar 
places, cautioning the workmen against those habits of 
carelessness most apt to occasion accidents. This might 
be stated briefly, and a few words added, advising against 
the use of poultices, lead washes, etc., and other noxious 
forms of treatment. 

'''Eighth. Finally, the Committee would strongly 
recommend in the medical colleges throughout the 
country, more attention be given by the faculties to the 
course ophthalmology, making it as long and thorough 
as the requirements of other branches will admit. The 
Committee is fully aware that in making these state- 
ments and recommendations regarding the causes and 
prevention of blindness it simply formulates in brief 
what is for the most part well known from similar obser- 
vations made in other countries. It is hoped, however, 



ESSAY. 153 

that the action of this body in recognizing formally the 
importance of the subject, may draw to it the notice of 
practitioners in general, and it seems fittihg that a 
society whose object is the advancement of ophthal- 
mology should also be the pioneer in any combined 
effort of the professionion for the prevention of blind- 
ness." 

LuciEN Howe, M. D., 

Swan W. Burnett, M. D., 
Joseph A. Andrews, M. D. 

In closing the compilation indicating the present 
status of the laws and action of various bodies in 
relation to the prevention of blindness in this country, 
i the writer would respectfully suggest that a committee be 

I appointed to consider the desirability of furthering legis- 

lative action in this direction, in the State of New Jersey, 
and that the committee, if appointed, be requested to 
formulate a suitable plan of action and to present drafts 
of circulars and proposed laws at the next meeting of 
this Society. 



REPORT 



OF 



STANDING COMMITTEE. 



REPORT OF S'l'ANDING COMMITTEE. 



Your Committee endeavored to procure a more ac- 
curate and concise account of the medical and sanitary 
condition of the State during the past year for presenta- 
tion to the Society to-day. 

Greater care was given in the preparation of the 
blanks in order to secure information from the members 
of the Society relating to the prevalence and mortality 
of disease, the administration of and progress in sanita- 
tion, their experience in treating cases of special interest 
in medical, surgical and obstetric practice, their judg- 
ment as to the best measures to prevent the introduction 
and to arrest the spread of cholera in a community, and 
to secure a complete record of deceased members. 

These blanks were sent in sufficient number to each of 
the reporters to supply every member of his County 
Society with a copy, on which was printed an urgent 
request for an accurate and prompt report. 

It needs no argument to prove that the value of most 
of the information desired is proportionate not only to 
the accuracy of observation, but also to the extent of our 
State covered by these observations — to the number of 
physicians reporting their observations and experiences 
to their respective reporters. 

Every county has now a District Society. These 
societies have, in general, been sustained with the 
usual degree of interest and prosperity. Gloucester 
and Salem report increased enrollment, attendence and 
interest. 



158 MEDICAL SOCIETY OF NEW JERSEY. 

The reporters of nineteen of the twenty-one County 
'District Societies (an unusually large number) furnished 
their reports within the specified time and are therefore, 
under our by-laws, entitled to seats as delegates ex-officio. 

But it is a matter of deep regret that these faithful 
reporters are compelled again to state that but a small 
proportion of their membership complied with their 
request for information on which to base their reports. 

Your Standing Committee is therefore compelled to 
present again a report unsatisfactory to themselves be- 
cause fragmentary, and therefore possibly inaccurate in 
its statements as to the prevalence, type and mortality 
of disease. 

We submit to the Society the question whether this 
time-honored custom of a lengthy annual report from 
your Standing Committee on — to quote the by-laws — 
**the general state of health of the citizens of New 
Jersey during the preceding year, the causes, nature and 
cure of epidemics (if any have prevailed) in any part of 
the State, curious medical facts, discoveries and remark- 
able cases that may have come to their knowledge,*' etc., 
should not be omitted hereafter, because the time con- 
sumed might be more profitably occupied, the proceed- 
ings of the annual meeting brought more in harmony 
with modern methods and usages, and the volume of 
Transactions be thereby enhanced in value to our 
members. To do so, however, would seem to require a 
change in Sec. 7, Chap. II, of our By-Laws. In obedi- 
ence to the requirement of said by-law we report to-day. 
We have been greatly favored during the past year 
with an unusual degree of exemption from severe 
epidemics and other forms of disease. Where epidemics 
have prevailed they have been restricted to a few 
localities; have been generally of mild type, with a small 



REPORT OF STANDING COMMITTEE. 1 59 

percentage of mortality. The zymotic diseases have, as 
a rule, been less prevalent, less malignant and less fatal. 
Some exceptions will be noted. 

An improved sanitary condition is reported from the 
counties generally, and this is doubtless attributable 
largely to the anticipated visitation of cholera this spring 
and summer. Some of the reporters, in fact, hint at the 
increased activity of health boards because of their fear 
of the scourge. In several counties there have been 
construction of sewer systems, or extension of existing 
systems, drainage of meadows, closing of infected or 
suspected wells, introduction of better water supply, 
ordinances to secure house-to-house inspection, sanitary 
plumbing, etc. Newark has appropriated $20,000 for a 
public Disinfecting Station, and Trenton has provided 
for Cremation Works for the destruction of garbage, etc. 

We are sorry to note one exception to this commend- 
able activity of our health authorities, reported in a 
town where an epidemic of diphtheria occurred. The 
school board acted promptly in closing the schools, but 
the Board of Health took no action. The reporter says : 
**The late secretary and inspector, a physician, removed 
from the township and advised the board that they need 
not elect any one in his place, as the assessor (a farmer) 
is perfectly competent to fill it.'* In the same county, 
one school district reports ninety-eight children unvac- 
cinated out of 402 scholars enrolled in seven schools. . 

"La Grippe" throughout the State has been less 
prevalent, generally of mild type and light mortality. 
Complications were mostly tonsillitis, bronchitis and 
pneumonia ; in some sections pleurisy, otitis media, 
gastro-intestinal catarrh. The Hunterdon County re- 
porter refers to a form of the disease characterized by a 



l6o MEDICAL SOCIETY OF NEW JERSEY. 

persistent and recurrent pharyngitis, simulating pertussis, 
seeming to be contagious, attacking whole families. 

In several counties it is noted that its first appearance 
was later than usual in the season, and, with a few 
exceptions, convalescence, was not so protracted. Two 
sudden deaths, in this disease, are reported from cardiac 
paralysis. 

Scarlatina is reported as having been less prevalent 
and severe. The exceptions are Passaic and Somerset 
Counties, more prevalent; Essex as very prevalent, 1769 
cases with 248 deaths in Newark (increase 1041 cases 
over last year); Salem, very malignant in some localities, 
death occurring in many cases in a few hours after 
initiatory symptoms, acute nephritis a frequent compli- 
cation. 

One sudden death in scarlatina is reported from 
pulmonary oedema. 

Rubeola.— Most of the counties report but very little, 
the exceptions being Cumberland and Passaic, moderately 
prevalent ; Monmouth, exceedingly prevalent but few 
deaths; Gloucester, severe epidemic in three localities 
affecting adults to an unusual extent, complicated with 
pneumonia; Middlesex, quite prevalent, at Cranbury, of 
severe type. 

Diphtheria. — The majority report few cases, or less 
prevalent. The exceptions are Essex, very prevalent, 
Newark 528 cases with 160 deaths (119 cases more 
than last year) ; Passaic, prevalent the entire year, 
but less number of cases, Paterson, 237 cases, mortality 
29 per cent. ; Monmouth, some towns had two epidemics 
quite malignant with several deaths ; Hunterdon, epi- 



REPORT OF STANDING COMMITTEE. l6l 

demic at Flemington, severe type, mortality 25 per cent. ; 
Gloucester, at Ewan*s Mill, severe type, twenty-five cases, 
one death. One case is reported of a pregnant woman 
delivered during an attack with no trouble following. 

Cholera Infantum. — Generally reported as much 
less prevalent. Exceptions: Bergen and Warren, as 
usual in larger towns where bad sanitary conditions 
exist ; Union, as very prevalent in Elizabeth. 

Dr. Davis, Camden County report says: "I have met 
with very little cholera infantum since doing away with 
tubes to nursing bottles and resorting to careful steriliza- 
tion of all food.'* 

Typhoid Fever. — Generally less prevalent. Essex 
reports in Newark a decrease of over sixty per cent, and 
attributes it to their new water supply. Exception, 
Gloucester, prevalent in two localities. One case is 
reported with three distinct relapses, lasting over three 
months, with recovery. 

Several cases are reported from Bergen County with 
supervening phlebitis, one case with phlebitis of both 
legs. 

The reporter of Camden, says of Camden City : " It 
can be said that cases of the disease can at any time be 
found in this city ; and unless it prevails to an unusual 
extent, its presence does not excite remark or alarm 
among the people." We note that 151 cases of the 
disease were treated in Cooper Hospital, that city, during 
the past five years. 

Intermittent and Remittent Fevers. — Most of 
the counties report not as prevalent. Camden reports 
"growing less each year,** (except Haddonfield). Hun- 
11 



l62 MEDICAL SOCIETY OF NEW JERSEY. 

terdon, but few cases as a primary disorder, more 
frequent as a complication in other diseases. Exceptions : 
Gloucester, at Westville, prevalent, the drainage of 
meadows is needed to give relief; Hudson, at Bayonne, 
prevalent ; Somerset, rather more prevalent ; Union, at 
Westfield, more prevalent and more protracted in re- 
covery, leaving patients debilitated and anaemic. 

Pneumonia. — Reported generally throughout the 
State not as prevalent. Exceptions : Mercer, Morris and 
Sussex, the average amount ; Bergen, Burlington, Essex, 
Hudson, more prevalent ; at Bayonne (Hudson) it was of 
severe type, mortality thirty-three per cent. ; Middlesex, 
at Cranbury, of severe type ; Camden, at Merchantville, 
very prevalent, complicated with pleurisy. 

Three sudden deaths in pneumonia are reported. 

Variola. — Monmouth County reports over seventy- 
five cases at Red Bank; Essex reports a few cases in 
Newark and East Orange ; Mercer, ten cases in Trenton 
with no deaths (107 cases with seventeen deaths were 
reported the previous year); Middlesex, two cases in 
New Brunswick; Passaic reports three introductions of 
the disease in Paterson, six cases in all, with one death. 

In all of these places prompt action by the health 
boards prevented further spread of the disease. In 
Paterson from fifteen to twenty thousand children were 
vaccinated. At Red Bank a large number of successful 
revaccinations are reported, and Dr. Cooper extols the 
superiority of bovine over humanized virus in stating 
that 200 cases vaccinated with the former, he had not a 
swollen or sufficiently sore arm to require treatment. 

Cholera. — The only case of true Asiatic cholera 



REPORT OF STANDING COMMITTEE. 163 

that occurred in our State during the year was that of 
James Carr, at New Brunswick, which is described in the 
Sixteenth Annual Report of our State Board of Health, 
page 291. Biological examination of the dejecta con- 
firmed the diagnosis after his death. The prompt and 
efficient action of the local board of health effectually 
stamped out the disease. 

We note also, in passing, the preparedness of our State 
Board of Health to meet, and their promptness in re- 
sponding to, all emergent calls, as evidenced in the 
above case. 

Other Diseases Reported. — Tonsillitis more preval- 
ent than usual in Union County and more obstinate in 
yielding to treatment. Cerebro-spinal meningitis, several 
cases in Bridgeton, Burlington County. 

Gastro-intestinal catarrh, epidemic at Bordentown in 
January and February, mostly among adults. 

Dysentery, severe epidemic in the village of Helmetta^ 
Middlesex, 350 cases, or nearly the entire population ; 
also at Jamesburg, same county, about 200 cases ; also 
at Flanders and Mendham, Morris County. There was 
a very small per cent, of mortality in each place. 

Nephritis, an unusual number of cases at Woodbury, 
Gloucester County. 

Nervous prostration, an unusual number of cases at 
Andover, Sussex County. 

An epidemic of hysteria, due to religious excitement, 
men as well as women being affected, is reported by Dr. 
Sherk at Cramer's Hill, Camden County. 

An epidemic of enteritis, caused by milk from slop-fed 
cows, occurred in a town in Gloucester County. 

Twelve cases are reported and described, of sudden 
death, mostly of cardiac or cerebral diseases, besides the 



164 .MEDICAL SOCIETY OF NEW JERSEY. 

six reported under la grippe, scarlatina and pneumonia, 
and the indefinite reports from Camden and Warren 
Counties of an unusual number of deaths from apoplexy 
and heart disease, or ** heart failure." 

Cases Reported. — Salem County. — Case of diabetes 
mellitus, ten per cent, of sugar in urine, with recovery 
under codeine gr. i t. i. d. and restriced diet till sugar 
disappeared, then liq. potass, arsenit. was given. 

Camden County. — Case of pernicious anaemia which 
yielded to treatment with arsenic. 

Essex County. — Case of Dupuytren's contraction cured 
by long splint and extension by rubber adhesive plaster. 

The surgical and obstetric cases reported as having 
been treated in private practice (with a remarkable 
degree of success) are of so great number that we are 
compelled to refer the members to the County Reports, 
which will be published in the Transactions. 

The annual reports from the hospitals and different 
charitable institutions throughout our State, show a 
decided increase of their work and usefulness over that 
of preceding years. One hospital reports about 800 
operations performed. 

These institutions generally have had exceedingly 
favorable results, and demonstrate that New Jersey 
presents a record which will favorably compare with 
those of her sister states for her open-handed public 
charity, generally wisely administered and with the most 
beneficient results. Surely the medical profession within 
her bounds have showed no lack of service or of skill. 

The reporter for Camden County questions whether 
their charity is not sometimes greatly abused in the call 
for gratuitous services to patients abundantly able 
to pay. 



'report of standing committee. i6s 

The following suggestions have been made as to treat- 
ment of disease including new remedies approved : 

In treatment of scarlatina, sponging lightly the entire 
body, head included, for the first few days, with a solu- 
tion of hydrarg. bichlor. i to looo, is recommended to 
modify and shorten the period of disease and render 
exfoliation innocuous. 

Ichthyol administered internally and applied externally 
in skin affections, especially tetter, and in form of fifty 
per cent, ointment for relief of pain in inflammatory 
rheumatism. 

Deodoform as fully equal to iodoform as an antiseptic, 
and free from odor. • 

Phenalgercine as a safe and certain antipyretic, and as 
excellent in acute articular rheumatism and neuralgias. 

Sulfonal in delirium tremens and neurasthenia. 

Oxygen in night sweats of phthisis. 

Europhen locally in catarrh and ulceration of larynx. 

Calomel, large doses, twenty grains every two hours 
until 1 20 to 200 grains have been given, in pneumonia. 

Burgraeves dosimetric granules of aconitin, digitalin 
and arsenite of strychnia in all disturbances ushered in 
by chill with subsequent -high temperature. Dr. Barker 
states that he has thus several times "jugulated" pneu- 
monia, convalescence being promptly established after 
twenty-four hours or less. 

Thymus serpellum as a specific for pertussis. 

Exalgine with quinine for neuralgia complicating or 
following la grippe. 

Lactate of strontium in albuminuria. 

Benzoate of sodium in treatment of albuminuria and 
uraemia, whether from functional or organic kidney 
disease. 

Arsenite of copper for nausea and vomiting. 



l66 MEDICAL SOCIETY OF NEW JERSEY. 

Hyascyamine in retention of urine from spasm of the 
sphincter vesicae in typhoid fever. 

latrol in cure of varicose ulcer of leg, and in chan- 
croids as much more efficient than iodoform, and without 
its odor. 

Antikamnia in obstetrical cases, as shortening labor. 

Antipyrin, antifebrin and phenacetine continue to be 
frequently mentioned favorably as antipyretics, and also 
papoid as having given very encouraging results in differ- 
ent forms of dyspepsia. 

It will thus be seen that many members of our pro- 
fession are using freely the new remedies which, during 
these later years, are so rapidly increasing in number. 

We would renew our caution, in last year's report, in 
reference to discarding the old and reliable remedies in 
our haste to try every new one ; and would urge dis- 
crimination and watchfulness, especially in the ad- 
ministration of the more powerful and depressing 
antipyretics. 

The Following Papers Have Been Received :— 

"On a Case of Carbolic Acid Poisoning,'* reported by 
Drs. J. H. and S. F. Ashcraft. (See under Gloucester 
County report). 

'* On a Case of Alcoholic Paralysis with Fatal Ha^mate- 
mesis,'* by Dr. I. M. Shepherd. 

" On a Case of Sudden Death in Pneumonia,** by Dr. 
Cornelius Shepherd. (See under Mercer County report). 

To the questions on cholera, propounded by your Com- 
mittee, we have received numerous replies. The subject 
has been given in these a wider range than we intended. 

In reference to the prevention of its introduction into 
our country, they suggest : (i.) The establishment of a 
strict quarantine against all infected ports. The general 



REPORT OF STANDING COMMITTEE. 167 

opinion seems to be that such quarantine should be 
under national rather than under state control. (2.) The 
stoppage of immigration. 

In reference to its introduction into 'the communities 
of our own State, after it has made its appearance in 
the country or at its ports, to which we intended to limit 
the replies, we have received many and valuable sugges- 
tions. We would refer to the various County reports for 
these, which we have given with somewhat of fullness. 

We give a concise outline of essential points that 
physicians, in our judgment, should observe and empha- 
size in times of threatened invasions. 

I. To Prevent the Introduction of Cholera 

INTO A Community. 

1. Inquire into the sanitary administration in your 
community and give your most energetic efforts to 
secure its improvement. 

2. Obtain the service of men of sterling character 
and superior executive ability as members of your Board 
of Health. 

3. Require frequent inspections and scrupulous clean- 
liness of all places, public and private, particularly every 
street and alley ; every sewer, drain, cesspool, vault and 
pit ; every dwelling, store and office, including the 
plumbing ; every yard, outhouse and stable. 

4. Cause all surface wells to be examined, and close 
up those which are found to be polluted. 

5. Establish or perfect a system for the daily removal 
and safe disposal, by fire if possible, of all garbage, 
sweepings, rags and other domestic refuse. 

6. Be prepared to skillfully and effectually disinfect, at 
public expense, all infected persons, clothing, baggage. 



l68 MEDICAL SOCIETY OF NEW JERSEY. 

vehicles and premises. Cause a supply of standard 
disinfectants to be kept ready for use by the health 
authorities. 

7. Exclude from the markets all unwholesome food. 

8i Provide and keep in readiness a suitable hospital 
for communicable diseases and make engagements with 
physicians and attendants in anticipation of the need of 
their services. 

9. Instruct the people in regard to the nature of the 
disease ; its mode of communicability ; the value of 
thorough sanitation ; how to live ; what to eat ; the 
importance of using recently cooked foods; the neces- 
sity for boiling drinking water; the uselessness of de- 
odorizers, and. the benefit to be derived from a liberal 
use of soap and water, and from pure air and sunshine. 

10. Prevent the entrance of infected persons and 
effects into your community. Isolate every "suspect.** 
Keep ready for reference Circular No. 45 of the New 
Jersey State Board of Health. 

II. To Arrest its Spread After its First 
Appearance in a Community. 

1. Provide competent employees to carry out rules 
and directions of physicians and Board of Health. 

2. Promptly and completely isolate all cases of the 
disease, and also all " suspects.'* 

3. Watch all apparently innocent diarrhoeas. 

4. Thoroughly disinfect all choleraic discharges from 
patients before emptying into place of deposit. Com- 
pletely disinfect all vessels, clothing, bedding and every- 
thing used by the infected person, or in the sick-room or 
house. Burn all garments and articles which are soiled 
by contact with the discharges. 



REPORT OF STANDING COMMITTEE. 169 

5. In case of death of patient, wrap the body in a 
sheet or blanket which is saturated with a solution of 
bi-chloride of mercury, i to 500, and pack the coffin full 
of powdered quicklime. Bury the body privately, with 
no attendants except those necessary to insure proper 
burial, at least five feet below the ground surface. 

6. Give information to the public as to the existence 
and progress of the disease. Discourage popular fear. 
Provide free medical service for the poor and have it 
promptly rendered. Urge upon the people the greatest 
care in the selection of digestible food, and its proper 
preparation by cooking ; present the danger from the use 
of unboiled water; the advantage of avoiding all ex- 
cesses. Especially urge upon the people the observance 
of the strictest cleanliness of person and surroundings. 

We would call the attention of the Society to a new 
movement inaugurated in Essex County. 

A medical commission has been organized in that 
County for the purpose of furnishing to the profession a 
pure cow's milk designed especially for clinical purposes, 
under a plan devised by Dr. H. L. Coit, of Newark. It 
is composed of six physicians residing in Essex County, 
with Dr. J. W. Stickler as chairman, who have entered 
into a strict contract with an experienced dairyman. 
They have also associated with them several well-known 
experts. We commend to the profession the investiga- 
tion of this plan and its workings, for we believe it to be 
an exceedingly valuable and practical movement that 
should be extended to, or duplicated in other parts of 
our State, and which under the safeguards provided in 
this scheme, promises a pure milk supply. 

The necrology of the year, as reported to your Com- 
mittee, is as follows : 



I/O MEDICAL SOCIETY OF NEW JERSEY. 

Atlantic — Dr. H. N. Uhler ; Bergen — Dr. George B. 
Parker; Cumberland — Drs. Enoch Fithian, J. Barron 
Potter; Essex — Drs. H. H. Tichenor, Wm. A. Smith, 
W. Nick Pindell ; Gloucester — Drs. Carlisle B. Week^, 
E. Seymour Wescott; Hudson — Drs. L. W. Elder, John 
Pindar, Beriah A. Watson ; Ocean — Dr. Wm. C. Stone ; 
Passaic— Dr. F. J. H ep worth ; Somerset — Dr. Chas. F. 
Phinney ; Sussex — Dr. J. Linn Allen ; Union — Dr. James 
S. Green, Sr. ; Warren — Dr. Wm. Shipman. 

Two of these were ex-presidents of our State Medical 
Society, Drs. Green of Elizabeth, and Watson of Jersey 
City. They were men eminent in their profession as 
surgeons and greatly esteemed. Their departure reduces 
the number of surviving past presidents of our Society 
to twelve out of a total of 105, the oldest of whom, but 
one of the most regular in attendance, the venerable Dr. 
Samuel H. Pennington, served in 1848. 

The already too great length of this report forbids just 
tributes to the memory of the faithful and honorable 
professional lives and services of the departed. Bio- 
graphical notices of some of them have been provided, 
and we shall endeavor to secure the others for publica- 
tion in the Transactions. We cannot, however, refrain 
from calling attention to the extreme old age of 100 
years, six months and five days attained by Dr. Enoch 
Fithian of Greenwich, Cumberland County, with the 
mental faculties retained to the last, a member of his 
County Society from its organization in 1818 — nearly 
seventy-five years. Surely we may say he passed away 
in the ripeness of a greatly honored and revered old age. 

DAVID C. ENGLISH, 

New Brunswick, N. J., June 26, 1893. Chairman, 



APPENDIX 



TO 



REPORT OF STANDING COMMITTEE. 



£n Mtmotiam. 



•  • 



J. LINN ALLEN, M. D., 

Bom July 13, 1820, 
Died January 29, 1893. 



LORENZO W. ELDER, M. D., 



Born 



-, 1820, 



Died May — , 1892. 



ENOCH FITHIAN, M. D., 

Bom May 10, 1792. 
Died November 15, 1892. 



JAMES S. GREEN, Sr., M. D., 

Bom July 22, 1829, 
Died July 2, 1892. 






5n Mtmoxmm. 



•  • 



F. J. HEPWORTH, M. D., 

Died May 12, 1893. 



GEORGE B. PARKER, M. D, 



CHARLES F. PHINNEY, M. D, 

Died November 29, 1892. 



JOHN PINDAR, M. D , 

Died April 11, 1893. 



WM. NICK PINDELL, M. D., 

Born December 25, 1828, 
Died August 4, 1892. 



fitt Mtmotmm. 



•  • 



J. BARRON POTTER, M. D., 

Born July i8, 1823, 
Died June 11, 1892. 



WILLIAM SHIPMAN, M. D., 

Bom May 6, 181 7, 
Died February 5, 1893. 



WILLIAM A. SMITH, M. D., 

Born March 30, 1820, 
Died August 4, 1892. 



WILLIAM C STONE, M. D., 

Bom February 21, 1856, 
Died February 5, 1893. 



fitt iitemoriam. 



• ♦• 



H. N. UHLER, M. D., 

Bom August 4, 1834, 
Died March 25, 1893. 



BERIAH ANDREW WATSON, M. D., 

Bom March 26, 1836, 
Died December 22, 1892. 



CARLISLE B. WEEKS, M. D., 

Bom September 4, 1849, 
Died September 19, 1892. 



E. SEYMOUR WESCOTT, M. D., 

Born August 27, 1859, 
Died June 17, 1892. 



OBITUARIES. 



•  • 



J. LINN ALLEN, M. D. 

Dr. J. Linn Allen, one of the best known physicians in Sussex 
County, was born July 13, 1820, in Hardyston Township, and died at 
his home in Lafayette, on January 29, 1893, after a long and painful 
illness. He was a son of the late Rev. Edward Allen. He graduated 
from the New York University in 1842, and previous to his removal 
to Lafayette practiced his profession in Beemerville and Branchville. 
He had a large practice and was well known throughout the entire 
County. 

Deceased was an honorary member of the Sussex County Medical 
Society, and has practiced medicine in Lafayette since 1862. He was 
a genial, whole-souled man and had many friends. He leaves a 
widow, who is the sister of William H. Bell, of Branchville, and three 
sons, Frank, of Newark, and William and Edward, of Dakota. 



LORENZO WELTON ELDER, M. D. 

Dr. Elder was born in Guilford, Chenango County, New York, in 
1820. His educational advantages were obtained at the District 
School in Guilford, after which he chose medicine as a profession, and 
entering the College of Physicians and Surgeons, New York City, 
graduated from that institution in 1847. 

He settled in Hoboken, N. J., and speedily secured a lucrative prac- 
tice which continued up to the time of his death in May, 1892. 

Dr. Elder occupied a prominent position in the various professional 
organization of the County, having been President of the Hudson 
County Pathological Society, and was a member of 'the District 
Medical Society of the County. From 1870 to 1872 he was physician 
to the Hudson County Hospital. He was President of the Board of 
Health and Vital Statistics of the County for many years, and from 

19 



> i/^i-,, e?^ ,^^'^^X-tVTa, 



OBITUARIES. 179 

1 85 1 to i86[ was brigade-surgeon of the state militia. He was 
deputy adjutant-general on the staff of ,Gen. Rodman M. Price. 
From 1859 to 1863 he was Superintendent of the Public Schools of 
Hoboken, and for three years was a Tax Commissioner for the city. 
He was Mayor of Hoboken in 1863, a critical period in the country's 
history, and contributed greatly by his loyalty and zeal to the recruit- 
ing scenes and furtherance of measures for the conduct of the war. 

He was a strong friend of the public schools and of the teachers, 
trying to secure competent ones and then looking out for their 
interests in every way. 



ENOCH FITHIAN, M. D. 

BY CHARLES H. DARE, M. D. 

Dr. Enoch Fithian, son of Joel and Elizabeth (Beatty) Fithian, was 
bom in Roadstown, Cumberland County, N. J., May 10, 1792, and 
died in Greenwich, N. J., November 15, 1892, having attained the 
patriarchal age of one hundred years, six months and five days. 

The Doctor came of a family that has produced many valuable 
and prominent citizens. His father was the first elected sheriff of 
this County, and held that important office during the War of Inde- 
pendence, and was elected first to the lower and afterwards to the 
upper branch of the State legislature. The Doctor never married. 
He studied medicine with his brother, Dr. Erkuries Fithian, of Swedes- 
boro, N. J., and attended lectures at the University of Pennsylvania, 
from which institution he graduated and began, in 181$, the practice 
of medicine in Roadstown, N. J. In June of the following year he 
formed a partnership with Dr. Wm. B. Ewing, of Greenwich, and re- 
moved to that village. This partnership continued until May, 1824, 
when Dr. Ewing retired from practice. Dr. Fithian then conducted 
the practice unaided until 1849, when having found the work too 
arduous he formed a partnership with Dr. E. M. Porter, who, after 
two years, retired and was followed by Dr. Nathaniel R. Newkirk, of 
Salem County, N. J., who continued as his associate until the retire- 
ment of Dr. Fithian from practice in 1856, after having been con- 
tinuously engaged for over forty years in an extended and lucrative 
practice. 

Dr. Fithian was one of the founders of the Cumberland County 
Medical Society, December 8, 1818, and was its first Secretary and 



l8o MEDICAL SOCIETY OF NEW JERSEY. 

later its President, and was at various times elected delegate to both 
the State and American Medical Societies. He attended one of the 
meetings of the County Society, held in Bridgeton, after he had 
attained his ninety-sixth year, and always manifested great interest in 
its welfare. At the time of his death he was one of our honorary 
members. 

His account books, some of the older ones of which it has been my 
privilege to peruse, show him to have been most careful in details of 
practice, as he gave along with each charge, the diagnosis of each 
case. It is surprising to the younger practitioner how often the 
charge, twenty-five cents, for venesection occurs ; evidently he had no 
fear of the man with his " potencies " and powders. The amounts 
charged would hardly satisfy the physician of to-day — his charge for 
obstetrical cases being five dollars. 

As illustrating something of the social turn of the Doctor, I can do 
no better than quote from an article published after the centennial 
anniversary of his birth : " He is a man of wonderful memory, and 
even at this advanced age (one hundred years) he has been able to 
pleasantly entertain a company of friends. Always a beautiful reader, 
a lover of poetry and fond of reciting it, he could add much to the 
enjoyment of an afternoon party. He was fond of music, and for 
fifty years leader of the choir of the Greenwich Presbyterian Church, 
of which he was a member." 

It is impossible to write of Dr. Fithian without giving too much 
prominence to the advanced age to which he was permitted to live, 
but to those who knew him best, this was but an incident in the life 
of this good and useful man. His refinement of character, his scholarly 
mind, his polite and courteous bearing, and above all his Christian 
■character, are all characteristics worthy of our emulation. In his 
■departing days he will have exemplified the truth of the Psalmist's 
words, " Mark the pefect man and behold the upright, for the end of 
that man is peace." 



JOHN PINDAR, M. D. 

Dr. John Pindar, of Hoboken, N. J., died at his residence there on 
Tuesday, April 1 1 , 1 893, aged sixty-three years. The cause of death 
was diabetes. He was born in the town of Middleburgh, studied 
medicine with the late Dr. S. B. Wells, of this village, graduated from 



OBITUARIES. l8l 

the Philadelphia Medical College in 1854, practiced his profession 
with Dr. P. P. Werner, at Barner\411e three years, then located at 
Schoharie, C. H. His office was located in the old Mansion House. 
At Schoharie he was a very successful practitioner for twelve years. 
He then moved to the place of his late residence. Here again, he 
soon had a large and lucrative practice, until his health failed about 
four years ago. For a term of years he was city physician of 
Hoboken. Twenty years ago he was appointed surgeon for the 
eastern division of the D. L. & W. R. R., which position he held at 
the time of his death. He was at one time Treasurer of Schoharie 
County. He was also a Charter Member of Council 99, Royal 
Arcanum. His wife survives him. He leaves no children. He was 
buried at the '* Old Stone Fort " cemetery at Schoharie. 



WILLIAM N. PINDELL, M. D. 

BY WILLIAM RANKIN, JR., M. D. 

Dr. William Nick Pindell was bom in Anne Arundel County, 
Maryland, on December 25, 1828, and died in Newark, N. J., August 
4, 1892. He was educated at Georgetown, D. C, and at St. John's 
College, Annapolis, Md., and received his degree of M. D. from the 
University of Maryland in 1848. During the war he entered the 
United States naval service and served as surgeon on various hospital 
ships at different naval stations. At the close of the war he resumed 
practice in his native state. In 1871 he removed to Newark, where he 
continued to reside and practice his profession until his death. 

In 1849 Dr. Pindell married Miss Lyles', of Anne Arundel County, 
Maryland, who survives him. 



J. BARRON POTTER, M. D. 

BY JOSEPH SHEPPARD, M. D. 

The subject of this sketch was bom July 18, 1823. His grand- 
father was Col. David Potter, who came to Bridgeton about the year 
^n^y purchased the dwelling-house on the northwest corner of 
Franklin and Broad streets, in 1771, and was engaged in the mercan- 
tile business. His father Jas. B. Potter, was also a merchant and 
prosperous business man, in this place, until 1865, when he died in the 
the seventieth year of his age. 



1 82 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Potter graduated at Princeton College in 1844. He then 
entered the office of Dr. William Elmer, and graduated in the Medical 
Department of the University of Pennsylvania in 1847, and subse- 
quently became associated with his preceptor, and very soon had an 
extensive practice, becoming, from his genial manners, a very popular 
practitioner, and, from his thorough education, a successful and 
scientific physician. His early practice was, to a great extent, in the 
country, especially in Hopewell and Deerfield Townships. 

He was appointed physician of the Cumberland County Almshouse 
and Jail in 1853, and held this position for several years— up to about 
the outbreak of the war. During and after the rebellion his practice 
was more confined to his native city. 

Dr. Potter was one of the founders of the Cumberland County 
District Medical Society at its re-organization in 1848, and was elected 
its first Secretary, filling the office for eleven consecutive years, dis- 
charging its duties with fidelity, punctuality and acceptance. He was 
President of the County Society in 1859; its Reporter in 1862, and 
subsequently, its Delegate occasionally to the New Jersey Medical 
Society, and to the American Medical Association. 

He was almost invariably present at the medical meetings at home, 
and took an especial interest in its progress and advancement. As a 
practitioner he was courteous, attentive, observing, self-controlled, 
and ever ready to respond to the calls of suffering humanity, either in 
the higher or lower walks of life. 

Owing partly to overwork he was, at one time, somewhat infirm in 
the middle part of his life ; but with this exception, although not of a 
robust constitution, was always active and enjoyed remarkably good 
health. His cheerful tone and temper made his life joyous and happy. 

Among his good qualities, from inheritance and education, was his 
active mind, retentive memory and pleasant manners. He was never, 
to the last days of his useful life, sad, sour or despondent, but al^yays 
had a cheerful word and a pleasant face with which to greet, cheer 
and help others. 

Among his students now living are Dr. F. L. Du Bois, Surgeon 
United States Navy ; Dr. Woodruff, of Elmer, N. J., and Dr. C. H. 
Dare of this place. 

He had great reverence and love for his church, its ministers, insti- 
tutions of learning, and its service. He was a true lover of nature in 
all its forms, " in earth, air, ocean, or the starry sky." 



OBITUARIES. 183 

Dr. Potter was especially fond of poetry, history and biography, 
and possessed a rare and valuable collection, particularly of ancient 
works, chiefly relating to medicine, theology and the natural sciences. 
Unfortunately, this collection was damaged a few years since by a fire 
and only a part saved in good condition. A few of the latter, with 
illustrations, were exhibited at the Centennial Celebration of the 
Broad Street Presbyterian Church, Bridgeton, N. J., July 26, 1892. 

Dr. Potter was also fond of animals and well acquainted with the 
flora, and birds of this and other states, and delighted in the study 
and culture of trees, vines and fruits. 

His correspondents, during his absence in Florida, can all attest to 
the pleasure he took Jn the culture of southern fruit. In one letter 
are these words : ** I have since added many more trees, am working 
among them every day, as I do at home in the summer. I find de- 
light and health. The air is resonant with songs of birds, and filled 
with the delightful perfume of the orange blossom. Everything in 
nature is lovely, and * Man alone is vile.' " 

Dr. Potter took quite an interest in Florida as a health resort, and 
gathered much useful information concerning **the land of flowers." 

Subsequently, to escape the winter cold at home, he bought 
property on the Calahoosahatchie River, in southern Florida, below 
the frost line, in a beautiful location. Here he spent two winters. 

His return to New Jersey this year was delayed longer than in- 
tended, and he was exposed very much to the rays of the sun and 
suffered with the heat. On his homeward journey, by rail, to Jack- 
sonville, he became worse. Here he was obliged to stop at a hospital, 
where he was dangerously ill, but having rallied somewhat he took 
passage, with a servant, for New York by sea, then his condition be- 
coming worse, he died on the steamer, off Charleston, S. C, June 
II, 1892. 

The tidings of his death was a sad surprise to his numerous friends 
at home, and they much regretted that he had not left Florida early 
in May, when in his usual health. 

His death was much lamented, and at his funeral, held in the First 
Presbyterian Church, June 15, 1892 ; very touching tributes on his life, 
character and memory, were made by his pastor, classmates and other 
friends. 

" Sleepe after toyle, port after stormie seas, 
Ease after paine, death after life, does greatly please." 



1 84 MEDICAL SOCIETY OF NEW JERSEY. 

WILLIAM SHIPMAN, M. D. 

BY J. H. GRIFFITH, M. D. 

Dr. Shipman died at ii o'clock on Sunday morning, February 5, 
I §93, from general debility and disease incident to old age, at the 
residence of the late David Weider, at Still Valley, Warren County, 
N. J., where he had made his home since the death of his wife, some 
years ago. 

The deceased was bom May 6, 1817, on the farm now owned by 
his nephew, William Shipman, one mile from Stewartsville, N. J. 

He was the son of Isaac Shipman, who was the second Sheriff of 
Warren County, N. J., from 1828 to 1830. 

The Shipman family settled in Warren County about the year 1740, 
and took a prominent part in the Revolutionary War. 

Dr. Shipman studied medicine with Dr. Stewart Kennedy, of 
Easton, Pa., and graduated, in 1838, from the Jefferson Medical Col- 
lege, Philadelphia, Pa. 

He practiced medicine over fifty-four years in Greenwich, Pohat- 
cong and Lopatcong townships, besides going over the line into 
Hunterdon County, N. J., and up to a few weeks before his death. 

He was very successful in his profession, and had an extensive 
circle of acquaintances and friends. The records of the Warren 
County Medical Society, do not show that he ever affiliated with 
that body. 

He was one of the few physicians of Warren County who con- 
tinued the practice of medicine for more than half a century. 

His funeral took place on Wednesday morning, February 8, 1893, in 
the presence of a large concourse of friends and neighbors, and his 
remains were interred in the old graveyard of the St. James' 
Lutheran "(Straw)" Church, in the midst of the scenes of his earthly 
labors. 



WILLIAM A. SMITH, M. D. 

BY W. RANKIN, JR., M. D. 

Dr. William A. Smith was bom at Guilford, N. Y., on March 30, 
1820, and died in Newark, N. J., August 4, 1892. He received his 
preliminary education at the Guilford Academy. He entered Geneva 
College, New York, first as a classical and afterwards as a medical 



OBITUARIES. l8S 

student and graduated in 1847. He practiced first, at Sidney Plains 
and afterwards at Norwich, N. Y. At the breaking out of the war in 
1 86 1, Dr. Smith enlisted and was appointed assistant surgeon to the 
89th Regiment N. Y. Volunteers, but was soon appointed surgeon to 
the 103d Regiment. On May 3, 1863, while on duty at Suffolk, Va., 
he was severely and very nearly fatally wounded by a musket ball. 
This wound rendered him unfit for service and he resigned his com- 
mission, but in January, 1864, he had sufficiently recovered to re- 
enlist and was appointed surgeon to the 47th Regiment N. Y. 
Volunteers, but was soon transferred to Jacksonville, Fla , where he 
was placed in charge of the general hospital. In July, 1864, he was 
placed in charge of the exchange of prisoners at the Savannah river. 
In this line of duty he was engaged at various places, having, mean- 
while, charge of the general prison hospital at Newport News until 
his appointment as health officer at Norfolk, Va., in which capacity he 
served till the close of the war, when he was ordered to his regiment 
and mustered out of service with his companions in September, 1865. 
At the close of the war Dr. Smith removed to Newark where he 
practiced his profession until his death, although he suffered at times 
greatly from his wound. Dr. Smith served as Alderman in Newark 
for four terms, and was elected County Clerk of Essex County in 
1877. At the time of his death he was a Vestryman of the House 
of Prayer. 

In 1847, Dr. Smith married Miss Elizabeth Wade of Guilford, who 
sur\'ives him. He also leaves a son and daughter. 



WILLIAM COOLIDGE STONE, M. D. 

BY I. H. PLATT, M. D. 

Dr. William Coolidge Stone died at his residence at Lakewood, 
February 5, 1893. He was bom at Brooklyn, N. Y., in 1855. He 
was the son of Doras Littlefield Stone, for many years president of 
the Hanover Insurance Company of New York. His childhood and 
youth were passed at Newburyport, Mass. He graduated at Bellevue 
Medical College in 1880. After serving as interne at Bellevue, he 
went abroad and pursued his studies at Freiburg, Vienna, Paris and 
London. Upon his return to New York he was associated in practice 
with Dr. William M. Polk of that city, who writes that the association 



l86 MEDICAL SOCIETY OF NEW JERSEY. 

was a most delightful one to him, and served to enhance the very 
high opinion which he had long entertained of Dr. Stone's abilities 
and character. 

He came to Lakewood in 1886, where he built up a large practice 
in which he continued till his death. He married Miss Kate Nichols, 
of New York city. He was a member of the New York Academy of 
Medicine, of the American Climatological Association and of the 
Society of the Sons of the Revolution. 

To Dr. Stone's high degree of natural ability was added a thorough 
training, the fruits of which were shown in the success which at- 
tended the practice of his profession, while his warm heart and gentle 
sympathy endeared him to a wide circle of friends, to whom his 
sudden and untimely death came as a profound and personal be- 
reavement. 

BERIAH ANDREW WATSON, M. D. 

BY ROY INGLIS, M. D. 

Beriah A. Watson was one of the most highly esteemed members 
of the Medical Society of New Jersey, having been for many years 
active and influential at its annual meetings and in its service ; elected 
as its President in 1889, and on retiring delivered at its annual meet- 
ing in 1890, a scholarly and able address: "A Historical Sketch of 
Surgery — Ancient, Mediaeval and Modern." (See Transactions of 
1890, pages 83-131.) He died on the twenty-second day of December 
1892, in the fifty-seventh year of his age, having been a victim of 
diabetes for nearly fifteen years. 

Dr. Watson was bom in the State of New York, near Lake George, 
on March 26, 1836, and was the third son of Percy and Marion 
(Place) Watson. At the age of seven years he attended the district 
school of his neighborhood and continued there until fourteen years 
of age. At that time he enjoyed the companionship of one Jonathan 
Streeter, a Quaker teacher of that locality. The association thus 
formed with such a man had a great influence upon him, and, being 
a close observer, the precepts and example of this faithful tutor had 
much to do in forming and moulding his character. Under his 
pupilage he not only acquired a good education, but also the studious 
habits which, in later years, gave him so complete a mastery over his 
work. For several years afterwards he taught school and thereby 



OBITUARIES. 187 

increasing his means to carry on his studies at the State Normal 
School at Albany. Approaching the age of majority, he now began 
to feel the importance of determining the means for his future 
livelihood. 

From an early age he had nourished and cherished the desire of 
studying law, and indeed he was no less qualified by natural abilities 
and training for the law than for medicine. A mother's love and a 
mother's desire, and at last her sudden death, determined his choice. 
This bereavement so affected him that his tender heart yielded to all 
the sympathies and wishes of her life. From that time he determined 
to carry out his mother's wish, and, accordingly, turned his thoughts 
in that direction and began a preliminary course of medical reading 
in the office of the late Dr. James Reilly, at Succasunna. N. J. In the 
fall of 1859 he entered the Medical Department of the New York 
University, and in 1861, receiving his degree of Doctor of Medicine, 
he immediately began the practice of his profession, at White House, 
N. J., remaining there until the autumn of 1862, when he appeared as 
a candidate before the New York Board of Medical Examiners, of 
which Dr. Valentine Mott was president, for the post of surgery in 
the United States Army. Having passed a creditable examination he 
entered the army hospital stationed at Newark. He remained in 
hospital service until the spring of 1863, and was then commissioned 
as assistant surgeon Fourth New Jersey Volunteers. He was soon 
relieved from this latter position and placed in charge of the Fourth 
Artillery Brigade, then stationed at Falmouth, Va. He was subse- 
quently ordered to return to the Fourth New Jersey Regiment, being 
commissioned surgeon with the rank of major. Soon after he was 
detailed as one of the operating surgeons of the First Brigade, First 
Division, Sixth Army Corps, and was ordered to take charge of the 
hospital of this Division, acting also as medical purveyor of the corps, 
performing the arduous duties of his respective offices in a prompt 
and most efficient manner. At the close of the war he retired to civil 
life and resumed his professional labors in Jersey City, N. J., establish- 
ing a large and lucrative practice. 

While advancing his own interests he did not neglect the interests 
of the profession. An act legalizing the dissection of human cadavers 
in this State was secured mainly through his efforts and those of Dr. 
J. D. McGill. Dr. Watson was one of the incorporators of the New 
Jersey Academy of Medicine, of which he was a fellow and president. 



1 88 MEDICAL SOCIETY OF NEW JERSEY. 

He was also a fellow of the American Surgical Association, perman- 
ent member of the American Medical Association, member of the 
New York Neurological Society, New York Pathological Society,. 
Jersey City Pathological Society and New Jersey Microscopical 
Society. He was also President of the Hudson County Medical 
Society. He was one of the organizers of the Jersey City Hospital 
and, in 1869, was appointed attending surgeon. In 1873 he was ap- 
pointed attending surgeon to St. Francis* Hospital and later to Christ 
Hospital. He was also consulting surgeon to Bayonne Hospital. 

Dr. Watson was a hard and devoted student, with a love for 
experimental investigation. He contributed largely to medical and 
surgical literature, derived mainly from observations founded on his 
own personal experience. Among the list of his contributions may 
be mentioned the following: 

**A Case of Facial Neuralgia, Treated by Extirpation of the 
Superior Maxillary Nerve." (Reprint from Medical Record, October 
16, 1871.) 

** The Pathology and Treatment of Chronic Ulcers." {New York 
Medical Journal, July, 1875.) 

"A Case of Haematoma of the Thigh; Two Operations; Death." 
(Medical Record, October 20, 1875.) 

" Femoral Aneurism Treated by Plugging the Sac : Death Caused 
by Hemorrhage from Deep Epigastric Artery on Eighth Day; 
Autopsy; Remarks." (American Journal of Medical Sciences, 
October, 1870.) 

"Cases of Rabies Canina Treated with Strychnia and Woorara; 
Recovery." (American Journal of Medical Sciences, ^yAy, 1876). 

"Woorara in Rabies; Report of Two Cases, with Remarks." 
(American Journal of Medical Sciences, Vol. Ixxiii, p. 413.) 

"Stomach Pump, Aspiration and Syringe." (Medical Record, 
Vol. ii, p. 805.) 

" Lever Exsection Sac." (Medical Record, Vol. xiii, p. 38). 

" Discotome." (Ibid, Vol. xiv, p. 78.) 

" Gunpowder Disfigurements." (Si, Louis Medical and Surgical 
Journal, Vol. xxxv, p. 145.) 

" Pyaemia and Septicaemia." (New York Medical Journal, Vol. 
xxvi, pp. 367-461.) 

" Disease Germs ; Their Origin, Nature and Relation to Wounds." 
(Transactions of the American Medical Association, Vol. xxix, 
p. 263.) 



OBITUARIES. 189 

"An Experimental and Clinical Inquiry into the ^Etiology and Dis- 
tinctive Peculiarities of Traumatic Fever." {Transactions of the 
American Medical Association, Vol. xxxii, p. 409, 1891.) 

" Woorara ; Its Medical Properties and Availability for the Treat- 
ment of Diseases." {Virginia Medical Monthly, Vol. ix. p. i, 
et seq.) 

** Lister's System of Aseptic Wound Treatment Versus Its Modifi- 
cations." {Transactions of the American Surgical Association, 
Vol. i, p. 205, 1883.) 

"An Experimental Study of Anaesthetics," (Read before the 
American Surgical Association, at Washington, D. C, April 30, 1884.) 

He contributed the chapter on " Pyaemia and Septiaemia," in the 
American System of Practical Medicine, edited by Wm. Pepper, 
M. D., LL.D., 1885, and also a chapter oh the "Operative Treatment 
of the Spleen," in Keating' s Diseases of Children, He translated 
quite extensively from the French and German, and published two 
volumes of note: "Amputations and Their Complications," 1885, and 
**The Sportsman's Paradise," 1888. 

Among the more recent works are a "History of Surgery" and a 
brochure on ''Experimental Study of Lesions Arising from Severe 
Concussions." He left an unfinished work on the "Surgery of the 
Spine," which he intended to have finished and put to press at an 
early date. 

Dr. Watson received the honorary degree of Master of Arts from 
Rutgers College, March 7, 1882. 

During the latter years of his life. Dr. Watson's affliction became 
so severe in its nature that at times he seemed scarcely able to per- 
form the active duties of his literary and professional work, although 
he was apparently wholly unconscious of the inroads his malady was 
making upon his strength and power of endurance. At length his 
friends prevailed upon him to go abroad for a season, and, accordingly, 
in 1887, accompanied by his daughter and niece, he crossed the 
Atlantic for study as well as recreation. He was received very flatter- 
ingly by many eminent medical men, both in England and on the 
continent. Dr. Esmarch, the Surgeon General of the Prussian Army, 
gave a reception in his honor, at his home in Kiel, and Dr. Billroth, 
of A'ienna, received him in a similar manner. He visited all the 
larger hospitals and medical institutions of note, to study carefully 
the more modern methods and ideas in the department of surgery. 



ipO MEDICAL SOCIETY OF NEW JERSEY. 

On his return home, three months later, Dr. Watson resumed the 
practice of his profession. He enjoyed fairly good health until the 
month of May, 1891, when he was severely injured by a fall from his 
horse. For two months he suffered from concussion of the spine and 
slowly gained sufficient strength to carry on his labors, but never 
again enjoyed the same powers of endurance which characterized the 
earlier years of his professional life. 

Dr. Watson was ever a keen sportsman. It was while in pursuit 
of this enjoyment — quail shooting — that he contracted his last illness. 
This dates back to the 1 5th of October last. On that day he started 
out with his friend, Dr. Phifer, of Shumway, 111., with whom he was 
staying, to hunt quail. He exposed himself to the chill air and early 
morning dews, tramping about for several hours until he became 
thoroughly fatigued. He returned to Dr. Phifer's house and in the 
evening experienced a severe chill followed by a profuse haematemesis. 
He came home soon after this, arriving in Jersey City on the evening 
of October 18. He sought the best medical advice, but without avail. 
His health steadily failed until the day of his death. 

Dr. Watson was a man of noble qualities of heart and mind. He 
had the gift of drawing men to him. A man of generous impulses, 
of high aspirations, of noble desires and a student of men and books. 
His life and his influence had not reached their full measure in the 
community in which he lived, when nature's debt was demanded and 
he passed into the presence of the Great Physician. 



CARLISLE B. WEEKS, M. D. 

BY S. F. ASHCRAFT, M. D. 

Carlisle B. Weeks, M. D., was born at Vincentown, N. J., Sept. 4, 
1849, and in this home of his youth received his early education. He 
early evinced a fondness for medical knowledge, and in 1873 became 
assistant druggist at the Philadelphia Hospital, and while there com- 
menced the study of medicine under the preceptorship of Dr. David 
Richardson, the chief resident physician of that institution, and 
entering the Jefferson Medical College, was graduated with honor 
in 1880. He then became assistant physician in the Insane Depart- 
ment of the Philadelphia Hospital. His spare time while there was 
given to attending lectures at the University of Pennsylvania, giving 
special attention to those on surgery ; but feeling this work too con- 



OBITUARIES. 191 

fining he resigned, after three years, to take up private practice at 
Mantua, N. J. He then became a member of the Gloucester County 
Medical Society and bore an enviable reputation for skill and knowl- 
edge among his fellow- workers. He found Mantua a fertile field and 
was soon well established in business. He continued in the good will 
of the people, and though his business grew he became ill — a pul- 
monary complaint manifesting itself — and he betook himself, much to 
the regret of the community, to Turkey, N. J., in "The Pines." 

He went to Forked River in 1888, but the damp sea air caused his 
illness to again appear and he was obliged to remove to Columbus, 
N. J. Here in November, 1891, he became a victim to influenza and 
it was seen that it had left him with phthisis most pronounced, despite 
which he continued to practice till March, 1892. He died at Mantua, 
September 19, 1892. 

He was married in 1888, to Miss Emilie G. Carre, of Mantua, 
whose faithful and devoted attention, no doubt, prolonged his life. 

His qualities were not of the kind that are most easily appreciated 
by the masses, especially on first acquaintance, and some persons 
thought him too reserved. This was not because of pride, or the 
want of a disposition to be social and friendly with those with whom 
he came in contact, for he was a man of thought rather than of 
words. He was even-tempered, generous and a true Christian. 



SEYMOUR WESCOTT, M. D. 

BY J. DOWN HERITAGE, M. D. 

Seymour Wescott was born August 27, 1859. He received a com- 
mon school education at Glassboro, N. J., and spent two years at 
Bryant & Stratton's Commercial College, Philadelphia, Pa. Fearing 
a sedentary life would predispose to the development of tuberculous 
disease — the cause of his mother's death — he decided upon the study 
of medicine, and entered the office of J. Down Heritage, M. D., at 
Glassboro, N. J., as a student during the summer of 1880. where he 
made remarkable advancement in the study of chemistry, materia 
medica and anatomy. He was exceedingly fond of anatomy and, 
having a retentive memory, became and remained a good anatomist 
and an excellent assistant in surgical operations. He was a hard- 
working student, which, being supplemented with good common 






192 MEDICAL SOCIETY OF NEW JERSEY. 

sense and an acute judgment, gave him a fair start at his matricula- 
tion at Jefferson Medical College, Philadelphia, Pa., in 1881, from 
which institution he graduated in March, 1883 — as one of the pro- 
fessors assured the writer, one of their brightest students. 

He began the practice of his profession at Glassboro, N. J., upon 
receiving his diploma, and -continued a successful, as well as skillful 
career to the time of his death. 

He was a good diagnostician and gave promise of becoming a first- 
class surgeon, being cool and collected under fire — not liable to lose 
his head under emergencies. 

He was about five feet six inches in stature, of full habit, of genial 
disposition, a congenial companion, a firm friend, who could not be 
turned from his allegiance by innuendoes or insinuations. 

He was an only child and truly loyal to his parentage ; a good and 
loving husband, and was passionately fond of an only daughter, three 
years old at the time of his death. 

He was married in 1887 to an exceedingly interesting and well 
educated lady, Miss Ecie Durell, daughter of Rev. E. Durell, of 
Woodbury, N. J. 

He died June 17, 1892, after short and painful illness, of acute 
gastritis. 



REPORTS OF DISTRICT SOCIETIES. 



•  •- 



ATLANTIC COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

The general health of Atlantic County has been very 
good during the past year. During the summer months 
we had the ordinary amount of sickness, consisting, 
principally, of gastro-intestinal troubles. 

During the winter there was a number of cases of 
scarlet fever in Mays Landing and vicinity. Two deaths 
with glandular enlargement, suppuration and kidney 
complication occurred.* One death, that of my own 
daughter, age eleven years and six months, was the first 
to occur, and was caused by the fever itself. The disease 
was characterized by a very high temperature, oftentimes 
reaching 105.6°, very great restlessness and delirium, and 
severe throat complication ; excessive and continued 
nausea and vomiting which ushered in the disease and 
were continued until within twelve hours of her death, 
which occurred six days after the initial symptoms. 

Ther£ has been an epidemic of influenza in Atlantic 
County, but not so general as during the two previous 
winters. Most cases were of a mild character and only 
few instances of acute lobar pneumonia followed. The 
disease lasted about one week and was followed, in some 
instances, particularly in the aged, by very slow and 
protracted convalescence. 

Dr. H. N. Uhler, who, one year and six months ago, 
moved from Philadelphia to Atlantic City, and who 
joined the Atlantic County Medical Society at its 

13 



194 MEDICAL SOCIETY OF NEW JERSEY. 

January meeting, died suddenly, three months after, at 
his home in Atlantic City. A post-mortem was held 
and death found to have been caused by fatty degenera- 
tion of the heart, with nephritis. 

I believe, in order to prevent cholera, clean streets and 
clean houses are things which are of the very first im- 
portance. Typhoid fever and diphtheria have their 
origin in matter out of place, in bad drainage, in foul 
and noisome surroundings, in the fetid, poisonous atmos- 
phere. They have all found the largest number of 
victims among the slums or among those whose environ- 
ments are squalid and foul. The public health should 
be the very first consideration of those in authority, v/ho 
should use their influence to make the sanitary condition 
of their city or town better than they have been for a 
good many years. The room for improvement is great, 
and the work of improvement cannot be begun too soon, 
nor too vigorously prosecuted. If the cholera should 
come it would find plenty of victims to prey upon under 
existing circumstances, and if it should not come there 
are other dangerous fatal diseases to take its place and 
do their deadly work as they have year after year, 
especially among the little children. 

There should be sanitary improvements in every city 
and town, and with these improvements there should go 
the most rigorous inspection by the Board of Health, in 
which too much carefulness cannot be placed to enforce 
sanitary conditions. It will not greatly matter how clean 
the streets in front of the houses may be if the houses 
themselves are filthy. Strict quarantine against all in- 
fected ports, stoppage of immigration and isolation of 
all cases, are means to prevent its spread. 

. H. C. JAMES, Reporter, 

Mays Landing, N. J., June 4, 1893. 



REPORTS OF DISTRICT SOCIETIES. I95 



BERGEN COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

So far as our towns havq been heard from, it seems 
that we have had about the average amount of sickness 
through Bergen County since our last report, except at 
Hackensack; here acute diseases have been unusually 
prevalent during the last six months. 

Influenza has visited this, as it has other localities. How- 
ever, it appeared much later in the season than formierly 
and has not been as severe or protracted. Dr. Wells, of 
Englewood, reports two cases in children of the same 
family, one of three years presenting severe catarrhal 
symptoms, a pseudo-membrane appearing, simulating 
membraneous croup, the temperature reaching 104^, soon 
falling to 100^, where it remained for four weeks; the 
temperature in the second case reaching 107^, accom- 
panied by delirium and Cheyne-stokes respiration, but 
falling to 104^ by the use of baths hourly ; after a week 
it fell to 100^ and remained at about this point for sixteen 
weeks. Dr. Wells also reports four interesting surgical 
cases, one of pyelitis, due to the presence of a large T 
shaped calculus in pelvis of left kidney. In this case 
there was a misleading history of traumatism, along with 
some symptoms which led to an operation on the right 
kidney. The patient died nine days after the operation. 
An autopsy cleared up all doubt ; a very small stone was 
found in the pelvis of the right kidney. The second 
case is that of compound comminuted fracture of both 
bones of both lower extremities, due to a railroad acci- 
dent. The third was the opening of the knee-joint by the 
passage of a wagon wheel over it. The fourth case — still 
under observation and apparently doing well — is that of 



196 MEDICAL SOCIETY OF NEW JERSEY. 

compound fracture of both bones of the right lower ex- 
tremity, with suppuration of the epiphysis above, the 
integument being torn for a distance of eight inches and 
the muscle perforated by the upper tibial fragment. The 
last three cases were treated conservatively — a few pieces 
of bone only being removed in the first — and most excel- 
lent results obtained. 

Other operations are : By Dr. St. John — For malignant 
tumors of the breast, all successful and patients alive at 
this date ; two for malignant auxiliary glands and seven 
capital amputations of limbs. By Dr. Currie — One 
vesico-vaginal fistula; one for appendicitis. By Dr. 
Tygert, of Carlstadt — Removal of uterine fibroid as 
large as foetal head at seventh month ; accomplished by 
the use of the small forceps as in labor, followed by 
chain ^craseur. 

Obstetrical : By Dr. Currie — A case of protracted 
labor which resulted in sloughing of vaginal mucous 
membrane, labia minora, sphincter ani, and lastly the 
bulk of the body of the uterus. Patient recovered, but 
menses have not reappeared after a lapse of seven 
months. 

New Remedies recommended : By Dr. Currie — Stro- 
phanthus as a heart tonic. By Dr. St. John — Phenal- 
gercine as a safe and certain anti-pyretic, and most 
excellent remedy in acute articular rheumatism and 
general neuralgias ; also deodoform as being a perfectly 
safe, sure and inexpensive antiseptic for wounds. By 
Dr. Neer — Ichthyol, administered internally and applied 
externally, in various skin affections, especially moist 
tetter. 

We have been visited by no marked epidemic other 
than as above stated. There have been additional sewers 
laid in Englewood, and here in Rutherford, twenty-five 



REPORTS OF DISTRICT SOCIETIES. I97 

thousand dollars have been expended in the construction 
of main sewers and outlets during the past year. 

All local boards of health are making every effort 
to meet cholera with intelligence and understanding^ 
in case it puts in an appearance. One good effect of 
the " cholera scare " has been to stimulate health authori- 
ties to greater interest and activity all along the line of 
contagious and preventable diseases. At Englewood, 
Hackensack, Boiling Springs and Rutherford, particular 
efforts are being made, and our sister counties may be 
sure that Bergen will be found abreast of the times in 
this respect. 

S. E. ARMSTRONG, Reporter. 

Rutherford, N. J., 1893. 



Pyelitis— Operation. 

BY JOHN A. WELLS, M. D., ENGLEWOOD, N. J. 

This case was apparently due to traumatism, the patient jumping 
from a burning house and striking on the crest of the right ilium. 
The temperature varied from 99 J to 104 degrees for many weeks, 
with no local symptoms whatever except the periodical , appearance of 
blood, pus, and renal epithelium in the urine. When this occurred 
the temperature would fall to nearly normal, rising with repeated 
chills, sweatings, etc., when the urine became clear. 

It was believed that there was probably, a renal or extra renal origin 
to the pus, although no tumor was present at any time and an opera- 
tion was repeatedly urged. After several months, the patient being 
practically moribund with sepsis, having four chills daily, temperature 
105*^ and pulse 140, consent was obtained to perform nephorraphy. 
The kidney was exposed in the loin, the pelvis freely explored by aspirat- 
ing needle and subsequently by the finger. No calculus could be felt — 
a few flakes of muco-pus only appeared in the rather free hemorrhage. 
The kidney was packed with iodoform gauze and the abdominal 
wound closed, except opposite the opening in the kidney. The 



198 MEDICAL SOCIETVT OF NEW JERSEY. 

temperature fell to normal and continued so for nine days. No 
further chills occurred, but vomiting continued and the patient died 
nine days after the operation. 

At the necropsy, a very small stone was found in the pelvis of the 
right kidney — of about the lumen of the ureter. A second stone of 
small size in the bladder, while the left kidney, which was apparently 
healthy, microscopically, was a mass of pus cavities, and the pelvis 
and upper half-inch of the left ureter was completely blocked by a T 
shaped calculus of large size. No urine whatever could have come 
from this kidney for some time, the calculus acting as a deeply-seated 
cork in the ureter. The relief to the symptoms, by the operation on 
the right kidney, was evidently due to dislodging of the small stone 
from the orifice of the ureter, and allowing the urine to escape freely 
by the loin. 



BURLINGTON COUNTY. 

To the Chairman of the Standing Committee, &c. : 

From the writer's observations and the experience of 
some two or three other members of the County Medical 
Society, who kindly assisted in furnishing material for 
this report, the health of the county at large during the 
past year has been better than for the two years preced- 
ing. As in previous years, the diseases "la grippe" and 
pneumonia were met with, but the number of typical 
cases of the first-named disease was small. What was 
specially noteworthy, was the fact that the disease did 
not make its appearanee until the early part of March ; 
mild in nature, and, save in isolated cases, without 
complications. In Bordentown and vicinity there were 
but few cases of pneumonia. In Burlington, Riverton 
and Columbus, the disease was more prevalent, but 
rarely fatal. 



t 



REPORTS OF DISTRICT SOCIETIES. I99 

• 

Under the head of eruptive diseases, namely, scarlet 
fever and measles, Drs. Marcy, Gauntt and Van Mater 
report very few cases and no fatalities. In Bordentown, 
there were reported to the health authorities 24 cases of 
scarlet fever, all of which recovered, During the year 
there were also reported for this locality, 76 cases of 
diphtheria, of which number 14 per cent. died. Most of 
the cases occurred during the spring and summer months. 

The other sections named report few cases of the 
disease. Cholera infantum claimed fewer victims during 
the summer of 1892 than in former years. An exception 
might be made to this statement in the experience of Dr. 
F. A. Gauntt, of Burlington, who had under his care 
eleven cases, four of which died ; the complications being 
convulsions and meningitis. Of typhoid fever, the same 
observer attended seven cases, with one death. Drs. 
Marcy and Van Mater report no cases. In Bordentown 
there were twenty-two cases, with a mortality of 18 per 
cent. Intermittent and remittent fevers prevailed but to 
a limited extent. 

During the months of January and February this 
locality was visited by an epidemic of ** gastro-intestinal 
catarrh,** the etiology of which could not satisfactorily be 
determined. Those attacked were mostly adults. The 
attacks were ushered in by nausea, vomiting, fever, gastric 
and abdominal pain, soon followed by free diarrhoea, in 
some instances the stools being dysenteric. The attacks 
were sudden in their onset, and, in the majority of in- 
stances, quickly responded to appropriate treatment. In 
the writer's experience, rest, restricted diet, small and 
repeated doses of calomel, succeeded later by salol, bis- 
muth, morphia and ipecac, gave most satisfactory results. 

As to the most effectual method of preventing the 
introduction of cholera into a community, and to arrest 



200 MEDICAL SOCIETY OF NEW JERSEY. 

its spread after its first appearance, Dr. Marcy tersely 
expresses the sentiment of most medical men of to day 
when he says, ** Rigid quarantine, isolation and the care- 
ful disinfection of all discharges promise the best results.** 

WM. H. SHIPPS, Reporter. 

BORDENTOWN, N. I. 



CAMDEN COUNTY. 

To the Chairman of the Standing Committee ^ etc, : 

The reporter of this Society distributed sixty blanks 
containing queries propounded by the Chairman of the 
Standing Committee of the State Society, with the object 
of obtaining authentic information of the diseases that 
have prevailed in this county during the past year and 
such other information bearing upon medical progress as 
the questions were calculated to elicit. Of that number, 
only eleven were returned. 

Your reporter has been impressed with the evident 
lack of interest the members take in this long-standing 
method resorted to by the State Society to secure an 
annual medical history of New Jersey. This indifference 
is the more surprising when we consider that by respond- 
ing to this request of the Standing Committee, every 
such one is constituted a local historian, a record of whose 
works will live after him so long as printed books endure. 
The information thus sought is not designed for the 
gratification of an idle and ephemeral curiosity upon the 
part of the State Society, but it is intended and expected 
that it shall be of present value to every physician in the 
State, as well as to those who may come after us. To be 
of real value, the reports should approximate to a com- 



REPORTS OF DISTRICT SOCIETIES; 201 

pleteness that can only be obtained by every member 
contributing the information that he alone may possess. 
Therefore, viewed in this light, I feel that every 
physician who is careless about this matter does himself 
an injustice, and, at the same time, he fails in a duty he 
owes to the profession at large. 

The inquiry as to the general health of the people 
during the year ending May i, 1893, has been replied to 
as follows : 

Dr. H. Genet Taylor says : " General diseases have 
been of milder type than during the previous year, and 
eruptive diseases less malignant.'* 

Dr. A. M. Mecray reports the general health fairly 
good. 

Dr. O. B. Gross says : " There was an average amount 
of sickness with marked increase of catarrhal affections 
from January 10 to March 10, 1893." 

Dr. O. W. Braymer says the general health of the 
community in his vicinity was good. 

The above refers to Camden City. 

From Haddonfield, Dr. John R. Stevenson reports 
that ** the general health has been above the average of 
former years. Notwithstanding the great severity of the 
winter and early spring, bronchial affections and pneu- 
monia have been less than usual and of a milder type.** 

Dr. John W. Marcy, of Merchantville, says that the 
health in that town has been unusually good. 

Dr. H. H. Sherk, of Cramer*s Hill, answers that there 
was '* considerable sickness ** in his neighborhood. 

The sanitary condition of Camden City is reported to 
be fair ; but none of the correspondents have knowledge 
of any sanitary improvements having been made during 
the year past. 

Dr, Taylor says, in this connection, that the smaller 



202 MEDICAL SOCIETY OF NEW JERSEY. 

streets and alleyways need a thorough cleansing, and he 
thinks the heavy rains of the past few weeks have been 
our best scavengers. 

Dr. Braymer remarks that there are too many houses 
in his locality that are not underdrained. 

The sanitary condition of Haddonfield is good and Dr. 
Stevenson says it will soon be much improved by the 
completion of street grading, whereby the rain-water will 
be drained off by numerous short lines to Cooper's and 
Newton creeks. 

The sanitary condition of Merchantville is reported to 
be as good as can be expected in a place without sewers, 
whereas Cramer's Hill is in an unsanitary condition and 
no improvements have been made in that particular in 
the past year. 

" La grippe " has prevailed in the county to a moderate 
extent only, and the type has been mild. The complica- 
tions have been pneumonia, bronchitis, rheumatism, men- 
ingitis, conjunctivitis and gastro-enteric troubles. No 
deaths are reported. 

Scarlatina has existed in a moderate degree only, and 
the type was mild. No unusual complications are noted. 

All the correspondents report that but few cases of 
rubeola have been treated, with the exception of Dr. 
Braymer, who says it has been quite prevalent, and it is 
reported that the disease is now epidemic at Cramer's Hill. 
The complications are stated to have been pneumonia 
and conjunctivitis. 

Diphtheria has prevailed to a much less extent than in 
former years. Dr. Mecray has treated twelve cases, with 
one death ; Dr. Gross had fifteen cases, with a mortality 
of 26 per cent.; Dr. J. G. Doran, four cases, with one 
death ; Dr. W. A. Davis reports a few mild cases, without 
deaths ; Dr. D. Benjamin also reports a few cases, without 



REPORTS OF DISTRICT SOCIETIES. 203 

deaths ; Dr. Stevenson says there have been two cases at 
Haddonfield, and Dr. Marcy has had about one-half 
dozen cases at Merchantville. Some of the members 
have not met with the disease during the past year. The 
types of the malady have ranged from mild to malignant 
with complications of membranous croup, paralysis and 
nephritis. 

It is evident that cholera infantum does not prevail in 
this county to the great extent that it formerly did, as 
about one-half of the correspondents report that they 
have had no cases of the disease during the past year. 
This improved condition is due, without doubt, to a more 
careful dietetic management of the infant, and, as bearing 
upon this point. Dr. W. A. Davis says : "I have met with 
very little cholera infantum since doing away with tubes 
to nursing bottles and resorting to careful sterilization of 
all food.'* The only cases of the disease reported have 
been as follows: By Dr. Doran, thirteen cases, without 
deaths ; Dr. Gross, about ten cases, with a mortality of 
20 per cent.; Dr. Sherk, three cases, with two deaths. 
Dr. Braymer reports it no more prevalent than usual in 
summer, with a mortality of 10 per cent. Dr. Marcy, of 
Merchantville, says he has met with the usual amount of 
cases and had one death. 

Typhoid fever has prevailed moderately in Camden 
City during the past year, but has not been epidemic. 
It can be said with truth, that cases of the disease can 
at any time be found in this city ; and unless it prevails 
to an unusual extent, its presence does not excite remark 
or alarm among the people. 

Intermittent and remittent fevers have also prevailed 
moderately in Camden City. Dr. W. A. Davis truthfully 
says "they are growing less each year;'* and Dr. H. 
Genet Taylor tells us why, when he reports ** malarial 



204 MEDICAL SOCIETY OF NEW JERSEY. 

diseases less frequently met with than in former years, 
owing to drainage and filling up of low grounds near 
dwellings." 

In Merchantville, malarial fevers have been ** unusually 
prevalent;** and from Haddonfield, "quite a number of 
cases *' are reported. 

Pneumonia has been *'very prevalent** in Merchant- 
ville, accompanied with an unusual amount of pleurisy ; 
whereas, in Haddonfield it has existed to a Ifess extent 
than usual. In Camden City the disease has prevailed 
to a moderate extent, and few deaths have resulted 
therefrom. But the reports indicate that the number of 
cases of the disease have been much less than in former 
years, and the percentage of mortality has not been 
as great. 

Dr. Sophia Presley reports a case of cerebral apoplexy, 
resulting in death ; and a case of uterine cancer, with 
operation, followed eventually by death of the patient. 

Dr. O. B. Gross has met with half dozen cases of 
urticaria, two of which were due to lobster-eating. 

Dr. D. Benjamin notes a number of cases of inflam- 
mation of the mucous membranes, particularly of the 
eyes and bowels. 

Dr. H. H. Sherk reports a local epidemic of hysteria 
due to religious excitement, which claimed its victims 
among the men as well as the women. Also a case of 
pernicious anaemia, which yielded to arsenic ; also a case 
of podalic version. 

Dr. John R. Stevenson reports a number of cases of 
abscess of the ear, resulting in one death. Also, an acute 
case of paroxysmal catarrh, following exposure in a 
sleigh-ride, attended with great pain in eyes and fore- 
head. The symptoms yielded to morphia and quinine. 

Dr. O. W. Braymer reports one case of post-partum 



REPORTS OF DISTRICT SOCIETIES. 205 

hemorrhage, one of placenta previse lateralis, and also a 
case of twin delivery, where the shoulder of the first 
child presented and the funis was prolapsed. This child 
was delivered by turning, but it was dead. The second 
child was delivered alive. 

Dr. O. B. Gross reports a case of locked head, with 
occiput in the hollow of the sacrum. Delivery by for- 
ceps under chloroform anaesthesia. The child lived, but 
the mother died on the sixth day from pelvic tissue 
sloughing and resulting sepsis. 

In view of the possible visitation of cholera to this 
country during the present year, the Chairman of the 
Standing Committee asks our opinion as to the best 
measures to prevent its introduction into a community, 
and to arrest its spread after its first appearance. 

Replies to these queries have been received from 
several members, two of whom. Dr. H. Genet Taylor and 
Dr. John R. Stevenson, have had practical experience 
with the disease. I, therefore, quote their remarks in 
full: 

Dr. Taylor says the best measures to prevent its intro- 
duction into a community are a " proper sanitary ad- 
ministration, and an intelligent local board of health to 
carry out the regulations of the State Board, with 
unlimited authority to establish a strict quarantine, if 
necessary." To arrest its spread, there must be '* com- 
plete isolation of cases, and all choleraic discharges from 
patients should be disinfected before emptying into place 
of deposit. Complete disinfection of all vessels, and 
soiled clothing, etc., that may come in contact with the 
patient. Competent trained attendents to carrj^ out 
rules and directions of physicians and Board of Health." 
Dr. Stevenson believes " the best measures are scrupu- 
lous cleanliness of public highways and drains, private 



206 MEDICAL SOCIETY OF NEW JERSEY. 

houses, outhouses, yards and premises- The removal, 
burial and combustion of all filth ; thorough disinfection 
of all of the above public and private places; the use 
of a sufficient quantity of disinfectants and their frequent 
repetition in hot weather. For disinfectants, lime, 
copperas and chloride of lime have proved efficient if 
enough were used, and are best adapted for private use, 
because they are cheap — can be easily purchased. The 
mode of handling is well known to th« public and are 
safe from poisoning or doing any injury to persons or 
property. Quarantine is efficient only when prohibitory. 
Any quarantine, except of clothing and baggage, is un- 
necessary, and then need be no longer than is required to 
disinfect them. Its first appearance requires the prompt 
cleansing and disinfecting of the house in which it appears 
and of the surrounding locality, if it has not already 
been done. Disinfection of discharges (hydrarg. bi- 
chloride, etc.) and disinfecting of soiled clothing and bed 
clothing, by boiling, heat or chemicals. If these be done, 
according to my experience, the germs can be destroyed 
and the disease stamped out in twenty-four hours.*' 

In reply to the question, "What are the best measures 
to prevent its introduction into a community,*' Drs. 
Gross, Presley, Davis and Marcey, each say strict quar- 
antine ; and Drs. Mecray and Braymer advocate rigid 
national quarantine. 

All are agreed that the best measures to arrest its 
spread, after its first appearance, are strict isolation of 
the patients, thorough disinfection of the patient's dis- 
charges, and fumigation of his effects; the drinking of 
boiled and acidulated water, combined with care in the 
selection of food. In short, the words isolation and 
cleanliness are the talismanic figures that are best calcu- 
lated to preserve us from this dread disease. 



RRPORTS OF DISTRICT SOCIETIES. 20/ 

Very few sudden deaths have been reported. Dr. 
Sherk notes deaths from " heart failures," and Drs. Gross 
and Presley have met with sudden deaths in apoplexies. 

Dr. D. Benjamin has performed a number of operations 
for adominal tumors of various kinds. 

Dr. O. B. Gross reports a thigh amputation, with re- 
covery ; three laparotomies and all recoveries ; two breast 
amputations for carcinoma and sarcoma, with recoveries ; 
amputation of prolapsed gangrenous rectum, with re- 
covery ; two severe strangulated hernias, both operations 
successful. 

Dr. O. W. Braymer performed coeliotomy for prolapsed 
and adherent ovaries, giving rise to great suffering. The 
symptoms were completely relieved by the operation. 

Dr. Daniel Strock reports an amputation of crushed leg 
by disarticulating at the knee-joint, with removal of the 
patella ; recovery. Also, as a result of the severe cold 
of the past winter, the removal of fingers or toes from 
six individuals. 

Apparently, few new remedies have been tested, as but 
two of the correspondents make mention of such use. 

Dr. Sherk speaks of ichthyol in the form of 50 per 
cent, ointment for the relief of pain of inflammatory 
rheumatism ; di thymol di iodide in the treatment of 
chronic ulcers, and sulfonal with phenacetine in 
rheumatism. 

Dr. Braymer says he has used lactate of strontium in 
certain forms of albuminuria with success. 

Dr. Daniel Strock has used salophen in rheumatism 
with gratifying results. 

An interesting event of the present year was the 
publication of the first report of the Board of Managers 
of the Cooper Hospital, of Camden, N. J. The hospital 
was opened for the reception of patients on August 11, 



208 MEDICAL SOCIETY OF NEW JERSEY. 

1887, and therefore this report gives the statistics of the 
work performed from that date to December 31, 1892. 

During that time, 1,871 patients have received treat- 
ment in the wards ; and in the out-patient department. 
11,671 cases were treated; 25,287 visits were made. A 
careful examination of the cases admitted and the results 
obtained by treatment, sufficiently indicates the excellent 
character of the work performed by the physicians and 
surgeons connected with the institution. The proxftnity 
of the hospital to the railroads entering Camden from all 
parts of southern and eastern New Jersey, and the fact 
that Camden is a manufacturing city, necessitates the 
admission of a large number of cases of injury by rail- 
road and other machinery. Thus, much of the surgical 
work performed is for the relief of this class of wounds. 

Of medical cases, a greater number of typhoid fever 
patients are treated than of any other single disease, 
there having been 151 cases admitted since the opening 
of the hospital. 

The last report to this Society chronicled the informa- 
tion that the Board of Managers of the Camden City 
Dispensary had recently erected a new building, and 
provided greater facilities for the treatment of the poor. 
There is nothing new in this connection to relate, except 
to note that, as in every other instance whqre a plant is 
enlarged, increased business results. 

While the erection of hospitals and dispensaries, and 
the work they perform are proper subjects for discussion 
in this report by reason of being legitimate items of 
medical news, yet it is q4iestionable if information of this 
kind is listened to by any medical body with unmixed joy 
or exultation. Of the making of places where disease 
may be treated without cost, there is no end ; and ordin- 
arily, where two or three physicians are gathered together, 



REPORTS OF DISTRICT SOCIETIES. 209 

you will find one in their midst who has the hospital or 
dispensary fever. It is meet that the worthy poor should 
have these institutions of succour when in distress , and 
the individual charitable work of physicians is greatly 
curtailed and may be entirely stopped, if he so wills, in 
communities where such charities abound. But more 
than this results. That spirit of independence and pride 
which prevents individuals from accepting charity is en- 
croached upon, and finally so fully blunted that the well- 
paid mechanic or houseowner will unblushingly receive 
both treatment and medicine without tendering pay. 
Thus, a system of doing good that was originally con- 
ceived in a spirit of sympathy for fellow-beings in distress, 
has reached a point where, really, an injustice is done to 
the profession which is the principle agent in conducting 
it. As the members of the medical profession are the 
chief sufferers by this abuse of their charitable work, 
therefore they are justified in considering measures for 
its correction ; and the matter is brought to your attention 
to-day, as one properly concerning the welfare of the 
members of this Society. 

Happily, death has not invaded our ranks since we last 
met in annual session, but our numbers have been 
reduced by voluntary withdrawals. Dr. J. Orlando White 
resigned from active membership, but was elected an 
honorary member. Three other members have removed 
from the jurisdiction of the Society and have been 

dropped from the rolls. 

DANIEL STROCK, Reporter. 
Camden, N. J. • 



14 



2IO MEDICAL SOCIETY OF NEW JERSEY. 

CUMBERLAND COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

The general health and sanitary condition of Cumber- 
land County has been better than for several years 
previous. The last report of the State Board of Health 
shows a diminished mortality for the County. 

The blanks issued by your Committee were sent out 
to twenty-three different gentlemen, and while only six 
had the courtesy to reply, these have assisted materially 
in the report. 

The returns for Bridgeton for the year ending May i, 
1893, are as follows: Scarlet fever, 157 cases; measles, 
46 cases; typhoid fever, 30 cases; diphtheria, 12 cases; 
cerebro-spinal meningitis, 5 cases. 

The prevalence of ** la grippe " has been light. The 
catarrhal symptoms mild and no serious cases reported. 

More cases of scarlet fever have been reported than 
anything else, and the number much less than the year 
before, but few cases of death reported. 

Diphtheria has been less frequent, and pertussis ^and 
varicella less prevalent throughout the County. 

The sentiment with regard to the prevention and 
treatment of cholera seems unanimous among the 
respondents, that cleanliness, disinfection and strict quar- 
antine are the best preventives. The instructions of the 
government should be faithfully and intelligently carried 
out. 

Dr. Snyder, of Greenwich, reports a case of acute 
articular rheumatism with very severe and serious endo- 
cardial, pericardial and valvular complications in a male, 
fifty-three years of age; recovered. Also, a case of 
violent congestion of the lungs in a male over seventy- 
six years of age, with recovery. 



REPORTS OF DISTRICT SOCIETIES. 



211 



During the past year two names have been dropped 
from the roll of honorary members of our Society by 
death, Dr. Enoch Fithian, of Greenwich, and Dr. J. 
Barron Potter, of Bridgeton. Both were singularly kind 
and generous in their disposition, faithful to the sick and 
suffering, and skillful physicians. Both were highly es- 
teemed by the Society. Obituaries have been prepared 

for publication. 

M. K. ELMER, Reporter. 

Bridgeton, N. J., 1893. 



ESSEX COUNTY. 

71:? the Chairman of the Standing Committee^ &c, : 

The general health of Essex County during the past 
year has been but fair. The unusually low death-rate, 
21.13, of 1 89 1, was much exceeded, reaching 25.71. The 
percentage of children under five was 42.51. These 
figures and the table below, were obtained from the 
report of the State Board of Health and apply to the 
year ending June 30, 1892. 



Essex County. 






Belleville 

Bloomfield 

Caldwell 

Clinton 

East Orange.. 

Franklin 

Livingston. ... 

Millburn 

Montclair 

Newark 

Orange 

South Orange. 
West Orange . 



Totals. 



19 

25 

5 
21 

49 

4 

. 3 

13 
40 

1520 

113 
22 

18 



1852 



vo«- 


C4 tf} 


%  


4^ Cm 


rt 


2P. 


l' 


*- i> 


« 4> 


M >. 


10 >. 


§^^ 


16 


9 


26 


12 


10 


30 


3 


2 


15 


4 


13 


13 


16 


17 


67 


3 




2 




I 


2 


7 


6 


7 


7 


II 


34 


975 


507 


1722 


68 


5? 


153 


13 


8 


22 


II 


9 


26 


1135 


651 


2T19 



s 



> V 



21 

36 
26 
20 
60 

I 

9 
10 

'37 

905 
80 

20 

27 



1252 






« 


• 
V) 

u 


91 
114 

52 

71 
210 

10 
15 

43 
130 

5641 

473 

85 

91 


29.17 
23-31 


189 

54 

63 

238 

13 
17 
51 

223 

4927 
541 

103 
79 


7026 


2571 


6567 



T3 d 
« O 

[t] O 



193.366 
20,288 



273.030 



Birth-rate, 24.05. 



212 MEDICAL SOCIETY OF NEW JERSEY. 

But few replies were received to the circular issued by 
your authority. Sixteen of the i6o blanks were re- 
turned. 

In Newark the general health was fair, comparatively, 
until the recurrence of " la grippe '* last March. There 
was much pneumonia, and among children, scarlet fever 
was very frequent and severe. 

From the Oranges comes the same report. Elsewhere, 
the infectious diseases have been infrequent and mild, 
except for a few cases of severe typhoid in Montclair. 
" La grippe *' was quite general, but usually mild. The 
small-pox invasion (in Newark) noted in our last report, 
ceased with the summer months. A new infection oc- 
curred this spring, but was promptly suppressed. The 
same experience obtained in East Orange, among the 
colored population, in February and March. 

There has been a remarkable decline in the prevalence 
of typhoid fever in Newark, which is generally credited to 
the excellent new water supply. A reference to the statis- 
tics given herewith shows a decline of about sixty per cent. 

Some precautions are being taken in anticipation of 
cholera, but in general, the sanitary conditions are re- 
ported as quite poor. 

The milk question. — A new departure has been made in 
Essex County during the year, which promises a material 
advantage to both the physician and the public. A 
medical commission has been organized for the purpose 
of furnishing to the profession a pure cow's milk, 
designed especially for clinical purposes. The plan as 
set forth by Dr. Henry L. Coit, of Newark, in a paper 
read before the Practitioner's Club, in January, is the 
basis for the work of the commission. The organization 
was effected by Dr. Coit, and is composed of six physi- 
cians residing in the County, Dr. Joseph W. Stickler, 



REPORTS OF DISTRICT SOCIETIES. 213 

chairman, Dr. William B. Graves, secretary, Dr. T. Y. 
Sutphen, Dr. L. E. Hollister, Dr. James S. Brown and 
Dr. Henry L'. Coit. These gentlemen have entered into 
a stringent legal contract with a dairyman, S. Francisco^ 
of Caldwell, N. J., who possesses unusual qualifications 
and dairy facilities. They have also associated with 
them the following well-known experts, who will supple* 
ment the personal supervision of the work : Prof. Albert 
R. Leeds, Ph.D., of Stevens Institute of Technology, 
chemist ; Rowland G. Freeman, M. D., of the Patholo- 
gical Laboratory of the College of Physicians and Sur- 
geons, N. Y., bacteriologist; Prof. A. Lentard, Professor 
of Anatomy, New York Veterinary College, Dr. W. B. 
E. Miller, of the Bureau of Animal Industries and E. 
R. Ogden, D. V. S., as veterinarians. The milk produced 
will be under safe-guards, even to the remotest possible 
sources of danger or contamination. The contract in- 
cludes sureties for its fulfillment, forfeiture clauses, and 
has reference to location of lands, character of buildings, 
the water supply, surroundings, conditions of the dairy 
stock, housing and care, feeding, collection and handling 
of the milk, the preparation of the milk for shipment, 
and the transportation and delivery of the same. 

Statistics, — The mortality in 1892, in Newark, was 
5,165. The population is estimated at about 200,000, 
giving a rate of 25.82. 

The following statistics were furnished by the Depart- 
ment of Public Health: 

Cases. Deaths. Compared with i^gi. 

La grippe 56 

Scarlet fever 1769 248 An increase of 1,041 cases. 

Diphtheria 528 160 " " 119 

Membranous croup.. 86 107 " " . 48 

Typhoid fever 222 85 Decrease of 387 cases. 

Malarial fevers 21 

Pneumonia 369 






214 MEDICAL SOCIETY OF NEW JERSEY. 

The extreme prevalence and severity of scarlet fever 
and diphtheria have been very notable. 

A public disinfecting station has been planned, and 
$20,000 was appropriated, as long as nine months ago, 
but no location has yet been found, the fear of local 
infection being alleged. Probably the blight of partisan 
political bossism is largely responsible for such delay in 
a highly commendable and necessary project. 

Cholera, — The opinions of the membership regarding 
precautions against an epidemic of cholera, while 
in essential agreement, are quoted individually. The 
answers to the two questions will be marked i and 2, as 
given in the first reply. 

What, in your judgment, are the best measures: i. 
To prevent its introduction into a community? 2. To 
arrest its spread after its first appearance ? 

Dr. George Bayles : i. — Extraordinary cleanliness; 
watchfulness on the part of health officers, and a sort of 
local quarantine. 2. — Strict isolation of the sick and all 
the " suspects ; " exceptional cleanliness in all sick-room 
management, and abundant disinfection within the sick- 
room, and for a zone of some width around the sick 
apartment. 

Dr. J. S. Brown : i. — Restriction of immigration and 
strict quarantine at ports. 2. — Absolute cleanliness of 
township and person ; isolation of cases by local boards 
of health. 

Dr. Joseph Fewsmith : i. — Cleanliness. 2. — Isolation 
and cleanliness, and sterilization of food. 

Dr. R. P. Harris : A strict system of quarantine, with 
detention of " suspects " and disinfection of clothing, etc. 

Dr. William B. Graves: i. — Most rigid quarantine, 
both national and local. 2. — The free and liberal use of 
acidulated drinks, and scrupulous cleanlines ^' about tene- 



REPORTS OF DISTRICT SOCIETIES. 215 

ment houses, and the placing of acids in drinking water 
used in shops, etc., where large numbers of people are 
congregated. 

Dr. J. J. H. Love: Place quarantine entirely in charge 
of the United States government. 2. — Isolation and dis- 
infection. 

Dr. R. C. Newton: i. — Perfect cleanliness; boil the 
drinking water ; avoid all excesses. 2. — Boil the drink- 
ing water ; burn everything that has been near the 
patient ; make all the attendants scrub their hands in hot 
water frequently ; put the community on sulphuric acid 
lemonade. 

Dr. William D. Robinson: i. — Cleanliness of the 
community. 2. — Isolation and proper care to be used in 
the quantity and quality of food and drink taken ; to 
attend to every diarrhoea as if it was cholera ; to abstain 
from fear. 

G. W. Rolerfort : i. — Absolute cleanliness and a strict 
quarantine. 2. — Immediate isolation of patients or per- 
sons affected ; destruction, by fire, of all clothing belong- 
ing to, or connected with said persons, and a thorough 
fumigation of quarters in which it originated, and quar- 
antining of said district. 

Dr. E. Schwartz: i. — Strict sanitary rules. 2. — Isola- 
tion and the utmost cleanliness. 

Dr. J. W. Stickler: i. — Keep infected persons and things 
out of the community. 2. — Prompt anAperfect isolation, 
with absolute disinfection of everything used by the 
infected person, or in the sick-room or house. 

Dr. H. B. Whitehorne: i. — Rigid quarantine methods 
at ports of entry. 2. — Strict isolation of the sick and 
their families, with enforced local disinfection, and 
general (also enforced) sanitation of the surrounding 
community. 



2l6 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. M. li. C. Vail: i. — Strict • quarantine against its 
introduction from foreign ports, and thorough funrfigation 
of affjected or suspected places and vessels. 2. — Strict 
quarantine of patient, burning of clothing and excrement, 
and thorough fumigation of buildings, rooms, etc. 

Sudden deaths, — Six cases are reported : 

By Dr. W. B. Graves : One on the third day after mis- 
carriage ; embolism suspected. 

By Dr. R. C. Newton : One from capillary bronchitis 
in a babe. One from pulmonary oedema, in case of pneu- 
monia, with pericarditis. " He was able to eat his dinner 
and felt pretty well at 2 P. M. ; before 7 P. M. was 
dead.'* Cirrhotic liver and kidneys were also found at 
the autopsy. 

By Dr. W. J. Stickler: One during "la grippe" from 
cardiac paralysis, probably precipitated by removal of 
patient from one room to another. 

By Dr. E. Schwartz : One in an infant after an illness 
of four hours, caused by eating of canned salmon. 

By Dr. T. W. Corwin : One during ** la grippe.'* The 
lungs had been characteristically affected from the fourth 
to the sixth day, when cardiac paralysis occurred and 
terminated life in six hours. 

Difficult operations, — Many such are daily performed, 
both at our hospitals and in private practice, but few 
reports are offerqji. One hospital alone reports nearly 800 
operations. The following cases have been presented : 

Dr. J. S. Brown : Several abdominal sections, ampu- 
tations, etc. No mortality. 

Dr. T. W. Corwin : Amputation of tongue, at base, 
for epithelioma, preceded by ligature of the lingual 
arteries and median section of the lower jaw. Recovery 
prompt and complete, but followed by recurrence of the 
disease in the cervical glands. 



REPORTS OF DISTRICT SOCIETIES 21/ 

Dr. J. Fewsmith : Have performed several "capital 
or difficult surgical operations." 

Dr. R. P. Francis : In November I operated, at the 
Mountainside Hospital, for appendicitis in a boy 14 years 
old. The appendix was adherent to the abdominal wall, 
and together with the abscess cavity,, was removed. The 
patient made a complete recovery that was complicated 
with a mural abscess. 

Dr. Wm. B. Graves : Coeliotomy for pyosalpinx : death 
from shock third day. Excision of hip ; tuberculous ; 
girl, 21 years old^, recovery. Laceration (complete) 
perineum ; primary union. Strangulated inguinal hernia ; 
male, 76 years ; primary union ; complete recovery. 
Suturing cervix immediately after laceration from par- 
turition ; two cases ; primary union. 

Dr. R. C. Newton : Operated for fracture of second 
lumbar vertebra, with double dislocation, in the Moun- 
tainside Hospital ; patient died. 

Dr. J. W. Stickler : Supra-pubic cystotomy for removal 
of calculus ; recovery. Amputations, lower extremities. 
Recto-vaginal fistula. Division of trachea from isthmus of 
thyroid gland to bifurcation of the tube, for removal of 
foreign body from left bronchus ; successful. 

In the above tracheotomy case, while cleaning trachea 
with a wipe, the gauze slipped into the left bronchus. 
The tube was seized on either side by forceps, the finger 
introduced and used as a guide on which. to separate to 
trachea longitudinally down to its bifurcation. By means 
of angular forceps the foreign body was removed. 
Shows possibility of removing bodies lodged in bronchial 
tubes by resorting to this operation. 

Query No. 6, elicited no replies. 

New remeaies, — A few responses were had : Anti- 
kamnia, phenacetine, europhen and ichthyol receive favor- 



2l8 MEDICAL SOCIETY OF NEW JERSEY. 

able mention. Aristol is commended for syphilitic and 
epithelial growths, and arsenite of copper for nausea and 
vomiting. 

Enquiry at the court-house shows that twenty-one 
physicians were registered as entering practice in the 
County during 1892, under the license of the State Board 
of Medical Examiners. The provisions for registration 
and licensing of midwives, coming also into effect, re- 
sulted in forty-eight such diplomas being recorded. The 
work of this board is, doubtless, of great value to the 
community. 

Mortality, — Three of our oldest members passed away 

during the year : Drs. H. H. Tichenor, Wm. A. Smith 

and W. Nick Pindell. Each had a considerable practice 

and " died in the harness." 

T. W. CORWIN, Reporter, 



GLOUCESTER COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

The health of this County for the past year has been 
very good. No complaints are laid to the sanitary con- 
dition, except at Westville, which is *Wery poor.*' This, 
however, is recognized, and an effort has been made to 
improve it by an " attempt " to drain the adjacent 
meadows. Vaccination is very much neglected. Exact 
figures as unattainable, but one enumerator of the school 
census reports, in his district, seven schools having four 
hundred and two children, between five and eighteen 
years of age, of whom ninety-eight are unvaccinated. 
This indeed shows a dangerous state of affairs. 

Our District Medical Society is flourishing more so 
now than ever in its history; our quarterly meetings 



REPORTS OF DISTRICT SOCIETIES. 219 

attract every member who can be present, and we are 
treated to instructive talks and papers by visitors as well 
as by home talent. 

EPIDEMICS. 

No marked epidemic has visited us although several 
diseases have been prevalent in certain localities. 

^' La gripped — Generally mild in type and very moder- 
ate in extent, although each member has met with a few 
cases. No deaths are reported. Pneumonia, broncho- 
pneumonia, bronchitis, rheumatism and gastric catarrh, 
are reported as complications either accompanying it or 
following it. 

Drs. Laws and L. M. Halsey have observed frequent 
feebleness of uterine contraction in labor, where patient 
has had influenza, requiring frequent use of the forceps. 

Scarlatina. — Scattering cases throughout the year in 
Woodbury and vicinity. Dr. Reading reports them mild, 
as a rule, but with one case of nephritis ; another case 
having heart failure and dying on the fourth day. 

Dr. Stout reports ten cases in vicinity of Wenonah, 
all recovered ; he treats principally with salol and tinc- 
ture of the chloride of iron. A few mild cases are 
reported in other parts of the County. 

Rubeola.— ^S^vtvt epidemic in Clarksboro, Mickelton, 
Paulsboro and their vicinity. It has affected adults to an 
unusual degree and frequently been complicated with 
pneumonia. Drs. Hunter, Oliphant and Laws report, in 
addition, rotheln, which has, in the experience of Dr. 
Oliphant, often left the patient with inflamed glands of 
neck and otorrhoea and otitis. 

Diphtheria. — Dr. Buckingham, of Clayton, reports two 
cases, both fatal ; he remarks on the bad sanitary ar- 
rangements and poor nursing in both cases. 



/ 



220 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Ashcraft reports a considerable epidemic at Ewans^ 
Mills in mid-winter. Attacked about twenty-five, mostly^ 
children and mostly mild, but with one death from inva-^ 
sion of the larynx. Notes a case happening in a 
pregnant woman, delivery during the progress of the 
disorder with no trouble following. The trustees closed 
the school and one of them disinfected the building by^ 
burning juniper berries through it. The Board of Health 
took no action in the affair. This board is in a state of 
torpor. The late secretary and health inspector, a physi-^ 
cian, has removed from the township and advised the 
board that they need not elect any one in his place as. 
the assessor (a farmer) is perfectly competent to fill it. 

Cholera infantum, — Only scattering cases. Dr. Hunter 
reports a mortality of four per cent. 

Typhoid fever, — Has been mild in its ravages, although 
quite prevalent at Williamstown last fall. Dr. H. H- 
Clark reports an epidemic confined to one double dwelU 
ing-house, in Thorofare, and affecting successive tenants. 
Cause supposed to be contamination of the well from a 
water-closet close by. Will mention here the excellent 
essay on this disease read before the Society last October 
by Dr. Hunter. It was indeed a complete resume of our 
latest knowledge on the subject. 

Intermittent and Remit te?it Fevers, — Are not reported 
only along the river. At Westville, adjacent to large 
meadows, they have prevailed to a large extent in types 
from mild to severe. Dr. Hunter has noticed the un- 
usual symptom of haemoglobinuria in five cases. He 
says : " These two fevers are present with us every fall 
and spring, and could be largely done away with by 
effectual drainage of the large meadows hereabouts." 

Pneumonia. — Very few cases reported. Dr. Bucking- 
ham reports four fatal cases out of twelve. Dr. Stout 



REPORTS OF DISTRICT SOCIETIES. 221 

reports eight lobar, one death ; two croupous, one death ; 
one lobar with pleurisy ; one lobar with whooping cough. 

CHOLERA. 

1. An entire unanimity of opinion for a rigid quaran- 
tine, which should be national, to keep it out of the 
country. " Keep the filthy foreigners out." 

2. Immediate and strict isolation ; rigid disinfection 
which must be sweeping in its extent. Watch all ap- 
parently innocent diarrhoeas. Use cooked food only, and 
water must be boiled before using. 

SUDDEN DEATHS. 

Dr. Buckingham : — One from heart disease; no autopsy. 

Dr. Reading: — Two cases; one from fatty degenera- 
tion of the heart in case of muscular rheumatism ; one 
from atheroma of heart in case of chronic interstitial 
nephritis, with general atheroma and commencing gan- 
grene of great toe. 

Dr. Ashcraft: — Four cases; no autopsies. One from 
valvular disease of heart. This man had been in a pre- 
carious condition for at least twelve years. One, presum- 
ably from fatty degeneration of heart, in a negro con- 
valescing from muscular rheumatism. He had a 
syphlitic history and general atheroma with an arcus 
senilis. One, from a colic due to eating indigestible 
articles, in a case of chronic diarrhoea ; really a case of 
rapid death, as was in pain about four hours. One, val- 
vular disease of heart in an old lady of 82, who had long 
been subject to chronic diarrhoea. 

CASES OF SPECIAL IMPORTANCE. 

Dr. Reading: — "Had one case of shoulder presenta- 
tion, with right hand and arm down. Used an anaesthetic 
and performed podalic version, saving both mother and 



222 MEDICAL SOCIETY OF NEW JERSEY. 

child.** Also, **A case of puerperal peritonitis from scar- 
latinal infection, two cases of the disease occurring in 
family at same time ; recovery/* Also, "I have had an 
unusual number of cases of nephritis during the past 
year, including three of chronic parenchymatous ne- 
phritis, with one death, and three of chronic interstitial 
nephritis, with one death from atheromatous degeneration 
of the heart. Also several during pregnancy, all recover- 
ing after labor.** 

Dr. Hillegass: — ** Performed craniotomy. The child 
measured nine inches across the shoulders and weighed 
fifteen pounds. The mother was in a very precarious con- 
dition for about four weeks, but finally made a good 
recovery.** 

Dr. Hunter: — Epidemic of enteritis, caused by milk 
from slop-fed cows. Cases occurred in four different 
families, and were all traceable to same herd of cows. 

Dr. Oliphant: — Two obstetrical. No. i, ** Was a lady 
who had borne three full-term children; when the last 
child was about three years old, I was called to attend 
the mother on December 24, 1891, in miscarriage at three 
months; on February 15, 1892, another miscarriage at 
about the same time, followed in September, 1892, by a 
full-sized foetus.'* No. 2, "Was a lady whom I had 
attended in two former births of full-term children. 
Four years following, which was on March 3, 1893, I de- 
livered her of a false conception (or otherwise mole) ; on 
April 6, 1893, I delivered her of another conception, of 
the same size and consistence, which was hard and oval, 
about the size of a large lemon.** 

NEW REMEDIES. 

Dr. Buckingham : — "Aristol for ulcers and wounds ; 
papoid in dyspepsia.** 



REPORTS OF DISTRICT SOCIETIES. 223 

Dr. Reading : — " latrol has been very successful in my 
hands in the cure of varicose ulcer of leg and also in 
chancroids, being much more efficient than iodoform and 
having the advantage of having little or no odor." 

I note the deaths of E. Seymour Wescott, M. D., of 
Glassboro, and C. B. Weeks, of Mantua, and forward 
obituary notices of each. I also add a paper on Carbolic 
Acid Poisoning, being the report of a case read before 
our District Society at its last quarterly meeting, which 
elicited a lengthy discussion. 

S. F. ASHCRAFT, Reporter, 



A Case of Carbolic Acid Poisoning. 

BY DRS. J. H. AND S. F. ASHCRAFT. 

On Monday morning, May 25, 1891, we were awakened at 6.30 
o'clock by a messenger stating that Phinehas I., had taken carbolic 
acid. Arrived there in less than half an hour after the poisonous dose 
and found the patient, a blacksmith, aged 58, lying across his bed 
unconscious, unable to swallow, breathing heavily and with a rapid 
and fast- weakening pulse. A strong odor of carbolic acid filled the 
room and at once pointed out the cause of the trouble. 

We obtained the following history : He had risen first and had 
made a fire and presumably done a few other chores, when he startled 
his wife, who had not yet risen, by rushing up stairs into the bedroom, 
and exclaiming " I am done for," fell unconscious across the beu. 
In the kitchen was found an unlabeled whiskey flask that contained 
carbolic acid, diluted with water, that had been taken from its usual 
place in the closet. This had been secured by one of the family as 
an external application for rhus poisoning, some months before, and 
had nearly set him crazy. It contained, as near as they could recol- 
lect, equal parts of carbolic acid and water. We determined to give 
him atropine, and not having it in a more available form, a gelatine- 
coated pill of atropine sulph. gr. 1-60 was crushed, dissolved the best 
we could and given hypodermatically with the almost immediate 
result of strengthening the respiration and circulation. This was 
repeated in fifteen minutes, and two hypodermic syringefuls of brandy 



224 MEDICAL SOCIETY OF NEW JERSEY. 

then given. He was soon able to swallow and milk was poured down 
him liberally ; this was followed by an emetic of zinc sulphate which 
produced considerable pain in swallowing. He then vomited, though 
of course but very little as the poison was taken on an empty stomach, 
but that little had the odor of strong carbolic acid. The pain caused 
him to talk and mutter, but he was not intelligible. Then more milk 
was given at short intervals, but nothing else. In one and one-half 
hours after the poisonous dose he could and did answer questions ; in 
another hour he told us how it happened, as follows : — 

On getting up he had a slight abdominal pain, and after doing a 
few odd jobs, mentioned above, thought that he would take a drink of 
rye whiskey for it, went to the cupboard, reached in and pulled out a 
flask and not finding a glass readily, without further ceremony, let it 
gurgle. He discovered his mistake before swallowing, but not in 
time to spit it all out ; he rushed out-doors spitting, then almost 
crazed by pain immediately ran up stairs and was unconscious before 
he could explain it to any one — only had time to say '* I am done for." 
Then all was a blank. 

No other treatment was given beyond what is stated, exJept that he 
drank freely of gum-arabic water and infusion of flaxseed for some 
days, and we confined him to soft diet as long as we could ; his urine 
was very smoky and smelt strongly of carbolic acid for four days. 
On the sixth day, contrary to our wishes, he rode sixteen miles in a 
buggy to Memorial Day exercises, but it did not hurt him. 

There has not been any stenosis of the oesophagus nor any trouble 
with it or the mouth or pharynx since the acute inflammation passed 
off. Incidentally we will say that he had been a constant sufferer 
from lumbago for years, but after this affair it left him for some time 
but has since returned. 

The main points of the case : — 

First, — Sudden unconsciousness. 

Second. — Small amount of carbolic acid taken; he estimates it at 
" half a swallow " of a largely-diluted article. 

Third. — Antidotal power of atropine. Only 1-30 gr. of atrop. 
sulph. was used, and as we had it in no other form than gelatine- 
coated pills, it is probable that not that much was dissolved in our 
solution. 

Fourth. — The gratifying results of treatment. It is no exaggera- 
tion to say that two little pills, the size of a pin head, saved his life. 



KtPORTS OF DISTRICT SOCIETIES. 22$ 

HUDSON COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

Early in May I received from your hands some forty 
blanks for distribution among the members of the pro- 
fession throughout this County, and I regret to say I 
have only received replies from .eight. The compilation 
of the answers to the questions are as follows : 

To question No. i, the answers came "fairly good,*' 
which answered the question as to the sanitary condition 
of the different sections of the County, and it is pleasant 
to note that some sanitary improvements have been 
made in the different parts of the County. This is 
largely due to the organization of local boards of health 
in townships under the State law and operated and con- 
trolled by members of local town committees together 
# with a health officer, who must be a physician. 

" La grippe ** has been considerable, general and wide- 
spread, in the County ; its character mild and the com- 
plications have been bronchitis, pneumonia, dysentery 
and " numerous,'* the mortality small, or none at all. 

Of scarlatina the writers say they have had a " few 
cases ** of mild type with only throat and kidney com- 
plications and the mortality ** few," ** small ** and "severe,'* 
according to the location from which the writers hail. 

Of rubeola they report a " few '* cases of " mild *' 
variety, with no complications and no deaths. 

Of diphtheria, a " few mild ** cases without complica- 
tions or mortality. 

In answer to question No. 3 — as to the best measures 
to prevent the introduction of cholera into the country — 
all reply ** strict quarantine ; ** and the same answer ap- 
pears to the question of its arrest after it has made its 

15 



226 MEDICAL SOCIETY OF NEW JERSEY. 

appearance, one gentlemen advising the restricting of 
immigration. 

In answer to question No. 4, three of the correspond- 
ents answered "no; " one says he had a "sudden death 
in an infant due to cardiac disease," one in " pneumonia," 
and " several *' have died suddenly who were afflicted 
with phthisis. 

None of the gentlemen say they have done any capital 
operations, except in the several hospitals with which 
they are connected. 

In answer to question No. 7, one gentleman says large 
doses of calomel, 20 grains, every two hours, until 120 
to 200 grains have been given, have given him entire 
satisfaction in pneumonia. 

Among those who have died during the past year, I 

wish to report the names of Drs. J. Pindar, L. W. Elder 

and B. A. Watson. 

J. A. EXTON, Reporter, 



Cases. 



BY FRED. M. CORWIN, M. D., BAYONNE, N. J. 

Acute pneumonia, — Man, aged 28, called at my office at 8 A. M. 
on March 7, complaining of a cold. Examination of chest revealed 
negative symptoms. Contrary to my advice, he went to New York 
and returned at 2 P. M., without, apparently, any serious results. At 
7.30 P. M., on the 8th, I found him with temperature 10 1^^, respira- 
tion 48, pulse 120, small and feeble. His condition remained 
unchanged until 11.30 A. M., when he developed (probably) a sudden 
oedema and congestion of the lung and died at 12.30 P. M. There 
was but a small area of dullness and bronchial breathing at the base 
of left lung, and no moist rales when I saw him at 7.30 A. M. 

A unique case of umbilical hernia, — Was admitted to Bayonne 
Hospital, October 31, at 7 A. M. There was a distinct history of 
intermittent fever for three weeks, for which she entered hospital. 
The hernia was as large as a child's head, skin thin and glistening. 



REPORTS OF DISTRICT SOCIETIES. 227 

and ulcerated in two or three places from friction of clothing. There 
was no complaint of pain in the tumor; bowels acted, and slight 
vomiting. 

At 5 P. M., after being in bed all day, and while lying on her back, 
a rent of four inches or more in length, occurred in the sac of the 
hernia, allowing ten or more feet of intestine to escape. Assistance 
was summoned, and in less then an hour after the mishap she was 
under ether. Then there was found that a constriction existed at 
what might be termed the inner ring. This was enlarged by incision, 
and an hour and a half spent in trying to replace the intestines, during 
which time no progress whatever was apparent. The patient was 
now seen to be failing rapidly, and before the wound was sewed 
up she died, apparently of shock. 



HUNTERDON COUNTY. 
To the Cltairman of the Standing Committee^ &c. : 

Your reporter regrets to say that but a few of those to 
whom blanks were submitted, for reasons best known to 
themselves, have responded. If, therefore, this showing 
is not all it should be, or might be, it should not be 
attributed wholly to his inefficiency in particular, but the 
negligence of the members in general. 

It may be pertinent in this connection to ask whether 
changed conditions longer necessitate, or even make de- 
sirable, the reporting of the district to the State Society 
upon matters pertaining to the health and sanitation; 
whether the carrying of the heavy burden put on the 
Standing Committee is appreciated by the profession ; 
whether some action could not be taken with advantage, 
looking to an improvement in the Transactions, so that 
they would at least be more in harmony with modern 
methods and usages. 

The general health of this County for the year ending 
May I, has been on the average quite good, the sanitary 



228 MEDICAL SOCIETY OF NEW JERSEY. 

condition fair, with no improvements in the latter 
reported. Scarlet fever has appeared here and there in a 
mild form with little tendency to spread. Dr. John 
Fritz reports twelve cases occurring in his practice at 
Stockton. 

But few cases of cholera infantum are reported, like- 
wise of measles and of typhoid fever. 

Intermittents and remittents still hover around. While 
it is true that but a few cases have appeared, yet a suf- 
ficient number to acquaint us with the significant fact 
that malarial poison is among us, more likely to get its 
work in as a complication than as a primary disorder. 

The /r^«^ form of pneumonia, so well known to the 
older practitioners and of which so little has been seen 
among us of late, seems on the point of returning as 
several cases of this type have been observed during the 
past winter and spring. 

In a few places, mostly in villages and towns, diph- 
theria has appeared, but not as a general epidemic. In 
Flemington it was especially virulent, Dr. John H. 
Ewing reporting thirty cases as occurring in his practice, 
with a death-rate of twenty-five per cent. Dr. G. L. 
Romine and Dr. E. W. Closson, report several cases in 
Lambertville and vicinity. 

Comparatively few cases of that form of influenza 
known as ** la grippe '* have appeared, but other and 
allied forms, more or less numerous and complex, have 
either accompanied it or followed in its wake, giving rise 
to no little sickness and not a few deaths, more for the 
number attacked than the ** grippe " itself. 

One of the forms alluded to was that of persistent and 
recurrent pharyngitis. Dr. W. E. Berkaw, of Annandale, 
writes of it under the head of " sore throat " : ** Many 
cases of tonsillitis and follicular sore throat have occurred 



REPORtS OF DISTRICT SOCIETIES. 229 

in my practice during the past winter. The peculiarity 
noticed was the marked liability of this condition attack- 
ing the same person two or three times during the 
winter.'* Another peculiarity, it may be added, was its 
predilection for certain localities; nor was it confined to 
the winter season, but with the advent of spring it took 
on its full armor and did most effective work. 

Ushered in by malaise, sore throat, chilliness, aching 
pains, often about joints, muscular soreness, fever, in a 
few days it would give rise in many cases to a scraping, 
rasping, paroxysmal cough, paroxysms often attended 
with whooping or vomiting. Whole families would be 
attacked, the older sometimes being the first to contract 
it, and at other times the younger. It seemed contagious 
beyond question. Its duration was about three weeks. 
Exposure to damp, chilly air would almost invariably 
bring on a renewal in full force. In this way not a few 
suffered from it for three months or longer. On inspec- 
tion the pharynx presented a roughened appearance, like 
raw beef, the parts most deeply congested extended up 
to the posterior nares and down to the glottis, in tracks, 
from which the epithelia were absent in part or wholly. 

The nomenclature accorded it was various, indicating 
how little it was understood: "sore throat,*' "bad cold,** 
" influenza,** " la grippe,** and, strange to say, " whooping 
c )ugh,'* to which it certainly bore a resemblance, but 
from which it surely differed in its general clinical fea- 
tures. 

Dr. Ewing reports having successfully performed in- 
tubation in a case of diphtheria; also recommends a 
spray of hydrogen peroxide in this disease. 

Dr. Fritz speaks well of hyoscyamine in retention of 
urine in typhoid fever from spasm of the sphincter of the 
bladder. 



230 MEDICAL SOCIETY OF NEW JERSEY. 

As to cholera, our sentiments may be voiced in saying, 
practically, we know little about it, and our hope and 
prayer is that we will not be compelled, by its invasion, 
to know more of it. 

G. N. BEST, Reporter, 

HOSEMONT, N. J., May i, 1893. 



MERCER COUNTY. 

To the Chairman of the Standing Committee, &c, : 

Compared with last year there has been much less of 
the contagious diseases in this County. Ninety cases of 
scarlatina were reported to the Trenton Board of Health 
— less than half as many as in the previous year. There 
were fourteen cases in May and January, the two highest 
months, and two in November, the lowest month. One 
hundred and seventy-two cases of diphtheria were re- 
ported, which is more than a third less than last year. 
There occurred about the same number of cases during 
each month of the year, except in April, '93, none were 
reported. We ascribe this diminution of zymotic diseases 
to the improved sanitation, in the way of sewers, closing 
of wells of drinking water (there are some still in use) 
and the more careful attention to the cleaning of streets. 
The disposal of garbage has been an annoyance and 
cause of anxiety, but our city fathers have decided to 
construct crematories for the destruction of it, and we 
therefore look forward to a continual diminution in our 
death-rate on the consummation of the efforts to secure 
improved hygiene in Trenton. 

Variola. — Small-pox again broke out in Trenton, in 



REPORTS OF DISTRICT SOCIETIES. 231 

August, and from then until January there were ten 
cases with no deaths. The year previous there were 104 
cases with seventeen deaths. At the first outbreak, the 
year previous, there was a general vaccination of the 
city, so that the second one was very easily controlled. 

"La grippe" was not prevalent until March and April,, 
when there was quite an epidemic with tonsillitis, pneu- 
monia and suppurative otitis media as the most frequent 
complications. 

Of rubeola, cholera infantum, intermittent and remit- 
tent fevers, not as many cases as usual are reported. Of 
typhoid fever, two more cases reported than last year 

To prevent introduction of cholera, I am told : ** Effec- 
tive quarantine at New York and at our railroad stations/* 
and " thorough sanitary measures.** To arrest its spread : 
** Isolation, thorough disinfection, burning of all excreta ;** 
" prompt medical service among the poor.** 

Pneumonia of sthenic type was prevalent during the 
winter and spring. Dr. C. Shepherd reports one sudden 
death, and sends an interesting account of it. 

Dr. Franklin reports a case of puerperal eclampsia at 
seventh month ; premature labor was induced ; child 
lived four hours; urine scanty and over half albumen. 
Therapeutics: pilocarpin, verat virid, vapor baths and 
sodae benzoas; recovery. He also calls attention to 
benzoate of sodium in the treatment of albuminuria and 
uraemia, whether from functional or organic kidney 
diseases. 

I send also a report of a case of "Alcoholic Paralysis 
with Fatal Haematemesis,** by Dr. I. M. Shepherd. 

C. F. ADAMS, Reporter, 



232 medical society of new jersey. 

Pneumonia— Sudden Death. 

BY CORNELIUS SHEPHERD, M. D., TRENTON, N. J. 

On April 26, I was called to see Miss , of Ewing, age 1 8, 

with pneumonia, the result of cold received the day before on return- 
ing home from Trenton in the car, and sitting by raised window. 
The right lung and the posterior part of the left were involved. 
Pulse 120 and temperature 104°, with pain in the right lung and a 
distressing cough. Being constipated, I gave her six tablets of 
calomel each containing a i of grain, to be followed by a pill contain- 
ing aloin, podophyllin, cascarin, each grain i, and ext. belladon, grain 
■J, which operated freely. 

To reduce temperature and pulse she took three minims of tincture 
of veratrum viride every two hours. Hot flax-seed poultices were 
kept constantly applied to the chest. On my second visit, finding the 
pain so severe and the cough distressing, I ordered i of a g^ain of 
morphia, to be taken at bedtime, to relieve the pain and to procure 
sleep, which had the desired result, but as the after-effect was un- 
pleasant, causing sick stomach, it was not repeated. 

From this time the case progressed favorably and satisfactory, and 
by the eighth day the respiration was almost clear, and the pulse and 
temperature were normal. Her appetite was now good and she was 
taking no medicine except a simple cough medicine occasionally. The 
poulticing was dispensed with, but the patient was kept in bed. On 
the tenth day she awoke from a sweet sleep, was taken with a fit of 
coughing ; the nurse raised her up thinking she was choking and she 
died without a struggle, in the nurse's arms. She had every care and 
attention from a trained nurse, and her death, so unexpected, is a pro- 
found mystery to me, for with thirty-two years of experience in prac- 
tice I have seen nothing like it. 



Alcoholic Paralysis with Fatal H^ematemesis. 

BY I. M. SHEPHERD, M. D., TRENTON, N. J. 

Mr. C. C, aet. 25, complained on October 21, 1892. of chills and 
fever, lasting a few days, followed by persistent vomiting and great 
pain on pressure over the stomach ; tongue coated, eructation of gas, 
with ejection, first of food, afterwards of clear watery fluid and Slimy 
mucus. 



RRPORTS OF DISTRICT SOCIETIES. 233 

On November 5, the al?ove symptoms disappeared. He then com- 
plained of numbness and tingling in the limbs, and, to use his own 
words, " he thought he was going to have another attack of paralysis, 
similiar to one he had on January 20, 1892, the result of exposure 
after an attack of scarlet fever," from which he recovered. 

On November 16, the predicted attack occurred, with sharp darting 
pains, like pins and needles, shooting down arms and legs. His 
family history was good — no venereal disease, but he had always been 
a constant drinker. The paralysis at first involved the legs, the 
extensor muscles being more affected than the flexors, wrist drop, and 
muscles were sore when grasped. His hands and feet were swollen 
and congested, pupils normal, hyperaesthesia and anaesthesia in dif- 
ferent parts of the body, patellar reflex absent, feet drop, no decided 
atrophy of muscles, persistent vomiting and constant delirium. 

On November 20 he vomited blood, containing two clots, three 
inches long, amounting to about one pint. On November 24, the 
vomiting was checked. 

November 25, deafness occurred followed by a chill, and tempera- 
ture, which heretofore had been normal, rose to 105®, pulse 132. 
Death took place November 26. No autopsy was allowed. There 
was general atrophy of muscles of arms and legs. 



MIDDLESEX COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

As reporter for Middlesex County I beg leave to make 
the following report for the year. As far as I have been 
able to ascertain the health of the County has been 
unusually good. 

No severe epidemics have visited us, with the excep- 
tion of Helmetta, where they have had a severe epidemic 
of dysentery, numbering three hundred and fifty cases, 
but with only four deaths. The cause seemed to be in 
the source of water supply. 

In New Brunswick, in the months of February, March, 
April and May, we were visited with an epidemic of 



234 MEDICAL SOCIETY OF NEW JERSEY. 

scarlet fever, which was of very mild type, there being- 
only six deaths in a total of 149 cases. 

Measles has been very rare, only seven cases being^ 
reported. In the spring months there was less sickness 
of all kinds than I have ever known before. 

The number of cases of diphtheria has been small, but 
quite fatal, there being twelve deaths in thirty-one cases. 

There have been only seventeen cases of typhoid fever 
in a population of nearly 20,000. 

This city has had one case of cholera during the year,, 
a full report of which has appeared in the report of the 
State Board of Health. By the most stringent measures 
the progress of the disease was checked. We report,, 
also, two cases of small-pox, confined to one family. Pre- 
cautionary measures were successful in stopping the 
spread of the disease. 

Dr. J. C. Holmes, of Cranbury, reports as follows : In 
April, influenza was quite prevalent, but of moderate 
severity ; no severe ** grippe " symptoms. Several cases 
of pneumonia; all qiiite serious. In May, pneumonia 
continues, and a few cases of scarlet fever; June, dis- 
tressingly healthy ; July, bowel diseases, cholera morbus 
and dysentery, gastro-enteritis, enteric colitis and cholera 
infantum ; August, less bowel diseases among adults, but 
an increase of same among children, several malignant 
cases of diphtheria ; September, rheumatism unusually 
common, several cases of measles ; October, doctors go« 
ing to poor-house ; November, a few cases of remittent 
fever; December and January, a few cases of measles; 
February, measles epidemic, in very severe form, pul- 
monary complication common ; March, measles still 
epidemic. 

Dr. H. D. Zandt, of Jamesburg, sends the following 
report : " La grippe," few cases and of mild type. 



REPORTS OF DISTRICT SOCIETIES. 235 

Scarlet fever, measles and diphtheria, all mild and few in 
number. Cholera infantum, moderate number of cases, 
some severe. Intermittent fever, five cases, all mild. 
Three hundred and fifty cases of epidemic dysentery, 
most all of them severe ; four deaths. 

He urges carrying out the suggestions of the State 
Board of Health in regard to cholera, and recommends 
isolation of person attacked, quarantine and disinfection 
of premises. 

Report from Metuchen : Exceptionally healthy year ; 
sanitary conditions fair ; no epidemics ; " la grippe,*' 
moderate in extent ; diphtheria, few cases and of mild 
type. 

Dr. Dana urges the more general use of codeine in 

place of morphine. 

A. VAN NEST BALDWIN, Reporter, 



MONMOUTH COUNTY. 

« 

To the Chairman of the Standing Committee^ &c. : 

Reports from the seven members of our Society who 
kindly rendered reports, and from inquiries from other 
sources, indicate, with my own observations, that the 
past year has been unusually healthfuL 

"La grippe" visitations of the two preceding years 
just passed, contrasts greatly with the effects of the late 
appearance and mild type of " la grippe ** of this year, 
as regards the general healthfulness of this part of our 
State. Complications of this disease, reported this year, 
indicate more of the rheumatic type and less of lung 
troubles than was observed last year. Pharyngitis, acute 
and severe, has been frequently observed in the first 
stage, this spring. 



236 MEDICAL SOCIETY OF NEW JERSEY. 

Several cases of scarlatina have been reported, type 
mild, with no deaths. Dr. J. B. Goodnough, of Long 
Branch, says: "I place great reliance upon sponging 
lightly the body all over, head included, every hour or 
two, for the first few days, with a solution of bichloride 
of mercury, i to 1000. This not only modifies and 
shortens the disease, but it destroys the poison on the 
cutaneous surface, and thereby renders the exfoliation 
perfectly innocuous — a great point gained. The medica- 
tion internally consists principally of tr. aconit if fever 
funs high, for a day or two, with aq. chlorinii right along 
every two hours. Quin. sulph., if indicated by feeble 
pulse, in quite moderate doses. Milk and beef-juice for 
nourishment. 

Rubeola has been exceedingly prevalent in Freehold 
and a few other places. The general type was medium, 
complications and deaths comparatively few. 

Diphtheria occurred in two epidemics in some of our 
towns; form quite malignant in its early appearance, 
with several deaths. Calomel, of all remedies, serving 
best in earlier stage, or up to disappearance of the mem- 
brane, two grains every two hours for three to six days, 
being well borne even by children three years old. Of 
course chlorine in all combinations are excluded during 
the administration of calomel. Whisky, brandy and milk 
are freely and regularly given until convalescence is well 
established. A poultice of Indian meal, eleven parts, 
common salt, one part, water, cold, suflficient to moisten, 
has served your reporter well in several cases this year. 

Cholera infantum and typhoid fever were much less 
frequently observed than usual, only nine of the latter 
disease being reported, with no deaths. Aromatic sul- 
phuric acid appears to be a favorite remedy in this fever 
with some. Bismuth sub-nitrate and salicylate of soda 



REPORTS OF DISTRICT SOCIETIES. 237 

combined are spoken of as useful in cholera infantum, 
while salol holds a prominent place in the treatment by 
some of our brethren. 

Prevention of these and other diseases, due to contin- 
gent causes, seems to have attained quite as careful 
considerations as that of treatment, when they actually 
occur. In this respect the physician is becoming more of 
a philanthropist than a personal financier, and, no doubt, 
will receive due commendation some time from the 
populace, while we believe that it will not escape the 
notice of Him whom we all ought to serve. 

Intermittent and remittent fevers and pneumonia have 
not been as prevalent this year as usual. 

Variola has been a visitor with great tenacity at Red 
Bank, over seventy-five cases being reported. Since Dr. 
Edward Field is expected to give a paper on this epi- 
demic nothing further need be added, save that from his 
report given to our County Medical Society, there seemed 
to be a spirit of pride quite prevalent among the mem- 
bers, of the efficient and daring work in the combat of 
this so-much-dreaded disease by one of our members. 

Vaccinations have been very numerous in the northeast 
part of our County. So many successful re-vaccinations 
occurred proves that it is unsafe to depend on one, or 
even two vaccinations in controlling an epidemic. 

Cholera — First, prevention by the most effective means 
consistent with commercial interests in preventing the 
cholera poison from entering our seaports from foreign 
countries. Second, strict quarantine of any cases occurr- 
ing here, with the best sanitary conditions obtainable for 
both the sick and the well, are the views sustained by 
the reports received, but no mention is made of treat- 
ment. As an item for consideration, allow me to refer 
to the observations of a personal friend who witnessed a 



238 MEDICAL SOCIETY OF NEW JERSEY. 

cholera epidemic oyer fifty years ago. He was owner of 
a large pearl ash works and employed a large force of 
men. During this epidemic not one of his men took the 
disease, yet it was prevalent in that vicinity, causing 
many deaths. Noticing the healthfulness of his men he 
began to consider, resulting in offering his observations 
and to commence urging the use of the wood-ash lye, 
diluted sufficient to drink, for all who were afflicted and 
as a prevention for the well. This report was very flat- 
tering, and in view of the intelligence and candor of this 
esteemed man, John Sedgebeer, now deceased, I do have 
faith in this line of treatment, sufficient to desire to 
learn of a fair trial of the remedy both by the mouth 
and as enemas. 

Under the head of surgical operations, Dr. D. M. 
Forman, of Freehold, reports two cases of amputations : 
one of the hand and one of the thigh ; also, removal of 
stone from the female bladder, and two cases of recto- 
vaginal lacerations, one old and one new, with recovery 
in all cases. 

Dr. Jas. E. Cooper, of Shrewsbury, reports about 200 
cases of vaccinations by bovine virus points, within the 
last few months, without a single case of swollen or sore 
arm sufficient to require treatment, an experience differ- 
ing very much from his former practice with humanized 
virus. 

Of new remedies, phenacetine, acetanilid, anti-kamnia, 
salol and sulfonal, were favorably mentioned for neurotic 
and rheumatic affections, 

I have no notice of the death of any one of our pro- 
fession in the County. 

F. C. PRICE, Reporter, 



REPORTS OF DISTRICT SOCIETIES. 239 

MORRIS COUNTY. 

7<? the Chairman of the Standing Committee^ &c, : 

From the reports received it is clear that in this sec- 
tion, at least, the past year presents nothing of unusual 
medical interest. 

" La grippe ** has apparently made its usual annual 
visitation, but with diminished intensity. As in previous 
invasions, all types were met with, the most frequent 
complications being bronchitis and pneumonia. The 
mortality has been almost nothing. 

Scarlatina, rubeola and diphtheria seem to have been 
nowhere severely epidemic. Dr. Rice met with twelve 
cases of scarlatina, with one death, and Dr. Pierson, six 
cases, with one death. All the others reporting either 
no cases or a very few. 

Of cholera infantum. Dr. Wigg alone seems to have 
met with more than the usual number of cases. 

Typhoid fever. — Dr. Flagge treated two cases and Dr. 
Pierson four; all recovered. 

Pneumonia has demanded no unusual attention, the 
winter and spring months presenting about the average 
number of cases only. 

Drs. Miller, of Flanders, and De Groot, of Mendham, 
report a mild invasion of dysentery in their respective 
localities, during the summer months. 

In reply to question No. 3, as to the prevention and 
management of cholera, the various measures recom- 
mended may be briefly summed up in the words of Dr, 
Barker, as follows: i. "Stop communication with in- 
fected centres as far as possible. 2. Complete isolation 
of * suspects * as well as well-marked cases.** 

Dr. Rice adds the following vigorous recommendation : 
^* Let competent medical men constitute the Boards of 



240 MEDICAL SOCIETV OF NEW JERSEY. 

Health, and politicians and popular men, who know 
but little about sanitation, and seem to care less, be 
relegated to the rear." 

Question No. 4. No cases of sudden death in pneu- 
monia are reported. Dr. Pierspn mentions a case of 
sudden death in scarlatina, from pulmonary oedema. 
Dr. De Groot also records a sudden death in cancerous 
disease of the upper jaw, attributed to some cerebral 
complication. 

Question No. 5. Dr. Condict, in consultation with Dr. 
Rice, of Port Oram, reports a fracture of the skull in a 
lad of ten years, the result of a kick of a horse. The 
injury caused a depression of the parietal and a portion 
of the temporal bone, resulting in complete unconscious- 
ness. The Doctor trephined, removing a button of bone 
which enabled him to elevate the depressed portion, which 
was followed almost immediately by a return of conscious- 
ness. The lad's recovery was rapid and complete. Dr. 
Flagge removed about three inches of the lower end of 
the radius, shattered by gunshot injury. The radial and 
median arteries were destroyed. Result — ** Thumb and 
index finger are devoid of sensation and motion ; look 
blue and often have sores upon them.** 

Question No. 6. Dr. Wigg reports two cases of ap- 
pendicitis, one resulting in resolution, the other the 
abscess discharging through the bowel, with ultimate 
recovery. 

Question No. 7. Dr. Condict records his disappoint- 
ment with the animal digestive ferments, and is now try- 
ing papoid, with encouraging results. 

Dr. Farrow is " pleased with the uniform and prompt 
effects of exalgine combined with quinine for neuralgia, 
accompanying or following * la grippe.' ** 

Drs. Barker and Pierson, of Morristown, have had 



REPORTS OF DISTRICT SOCIETIES. 24I 

satisfactory results in the use of Bourgraeve's dosimetric 
granules of aconitine, digitaline and arseniate of strychnia, 
**in all disturbances ushered in by chill, with subsequent 
high temperature." Dr. Barker states that he has "thus 
several times * jugulated* pneumonia, convalescence be- 
ing promptly established after twenty-four hours; and 
on several occasions I have remained in utter ignorance of 
the real cause of the attack, because convalescence was 
established after twenty-four hours or even less." 

E. P. COOPER, Reporter, 



OCEAN COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

The amount of sickness in this locality has been light, 
in comparison to last year. The extent of *' la grippe" 
was very light, while in some parts of the County we had 
scarlatina, rubeola, typhoid fever and pneumonia; the 
mortality was small. 

The sanitary condition is fair ; no improvements made 
during the year. I have mailed blanks to be filled and 
returned by physicians, but, I am sorry to say, I have 
only received a few, so that a report is made with 
difficulty. 

Necrology. — Death entered our Society, claiming Dr. 
W. C. Stone, of Lakewood, February 5, 1893. The 
Doctor was a man of profound learning, excellent judg- 
ment and he had a host of friends, both among his pro- 
fessional brethren and the laity. 

I. W. KIRK, Reporter, 
Manchester, N. J. 

16 



242 MEDICAL SOCIETY OF NEW JERSEY. 

PASSAIC COUNTY. . 
To the Chairman of the Standing Committee^ Src, : 

The health of the city for the past year has been up 
to about the usual standard. There were 321 cases of 
scarlet fever reported during the year ending April 30, 
1893, with a mortality of about five per cent. Typhoid 
fever was with us to the extent of 118 cases; mortality, 
twenty-one per cent. 

Diphtheria prevailed throughout the entire year, but 
to a less extent than in the previous year; number of 
cases, 237 ; mortality, twenty-nine per cent. 

The ** grippe " again appeared this spring, but was very 
mild and irregular in form. 

Measles and mumps were quite prevalent among the 
school children this spring. 

During June of last year there was considerable anx- 
iety awakened by the appearance of small- pox in the city. 
Three cases were reported at about the same time, two 
of which were traceable to the cases occurring at Passaic 
City. They were immediately removed to the City 
Hospital, the houses thoroughly fumigated and the in- 
mates vaccinated and quarantined. One of the cases 
proved fatal. In view of a probable epidemic, the Board 
of Health ordered a general vaccination of all school 
children (who were unable to show a proper scar) be- 
fore they could attend school, and appointed an official 
vaccinator for that purpose. The local physicians were also 
kept busy for about two weeks vaccinating their patients, 
with a result that there were some fifteen to eighteen 
thousand people vaccinated. Owing to the prompt 
measures adopted by the Board, there were no new cases 
developed, and the excitement gradually abated. In 
September, a case was discovered in a large tenement ; the 



REPORTS OF DISTRICT SOCIETIES. 243 

patient was a newly-arrived emig^rant. In March, of this 
year, a tramp applied at the police station for lodgings^ 
who was suffering from a well-developed case of small- 
pox ; he was supposed to have contracted the disease in 
Newark, where he had come from. In April, a case was 
imported from Mexico by a returning tourist. The same 
measures were adopted in these cases by the Board with 
the same result ; all of them recovered. 

The annual reports from the hospitals and different 
charitable institutions throughout the County, show a 
decided increase of their work and usefulness over that 
of preceding years. 

On May the 12th, this year, Dr. F. J. Hepworth died 

of consumption, after an illness of two or three years. 

He was an Englishman by birth, 38 years old, graduated 

at the Long Island College Hospital in 1880, and has 

practiced medicine in this city for eleven years. Last fall 

he went to Florida for the winter, but continued to get 

worse and died at Charleston, S. C, on his way back to 

Paterson. He leaves a widow, but no children. AU 

though the Doctor was not a member of the District 

Society, he was respected by the medical fraternity^ 

throughout the city. 

J. WM. ATKINSON, Reporter, 



SALEM COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

The amount of sickness in Salem County this last year 
has been greater than usual. The reports sent out were not 
returned, but having attended the County Society regu- 
larly, I am able to judge fairly well of the healthfulness 



244 MEDICAL SOCIETY OF NEW JERSEY. 

of the County. At our County Society this year we 
have had interesting papers read by Drs. Shimwell, Hare, 
Turnbull, M. Price and others, which have been very 
entertaining and instructive. 

Scarlet fever continues to be an epidemic with us, 
being of a more severe type than last year. In some 
localities it is very malignant, death occurring a few hours 
after the initiatory symptoms, and the more protracted 
and slight cases were often complicated by acute 
nephritis. In Quinton, diphtheria was epidemic during 
winter months ; with these exceptions, there has been 
no decided epidemic in the County. 

During the summer months we had the ordinary 
amount of gastro-intestinal trouble among children. 

The reporter had an interesting case of diabetes 
mellitus, which was treated through Dr. Tyson, of Phila- 
delphia ; there was present ten per cent, of sugar in the 
urine. The sugar completely disappeared in about two 
months with restricted diet and codeine i gr. t. i. d. 
After the sugar disappeared he was kept on restricted 
diet and Fowler's solution with good results thus far. 

The sanitary condition of the County is fairly good. 

W. S. PATRICK, Reporter. 

WOODSTOWN, N. J. 



SOMERSET COUNTY. 

To the Chairman of the Standing Committeey &c. : 

The fall and winter have been unusually healthy. 
During the year sewers have been considerably extended 
in Somerville. The sanitary condition is excellent. La 
Grippe has been prevalent to some extent during March 
and ApriL Dr. Stelle, of Bernardsville, reports that 



REPORTS OF DISTRICT SOCIETIES. 245 

pneumonia, as a complication, has occurred in a much 
larger per cent, of cases than in former epidemics. 
There has been a larger number of scarlet fever cases 
than usual. In one family, where it was of a particularly 
malignant type, four out of five children attacked died. 
There has not' been as much rubeola, diphtheria and 
cholera infantum ks usual. Dr. Fisher, of Bound Brook^ 
reports remittent and intermittent fevers as rather more 
prevalent than usual. A number of cases of typhoid 
fever occurred in Raritan and Somerville last fall. 

Dr. Merrill, of South Branch, reports that he has tried 
anti-kamnia in a number of obstetrical cases and he 
thinks that it shortens labor. 

A case of appendicitis with the formation of an abcess 
occurred in my practice. An operation was done by Dr. 
Donohue, of New Brunswick, and, with the exception of 
a faecal fistula, which I expect to heal spontaneously, 
the patient is doing well. 

On November 29, 1892, Dr. Chas. F. Phinney, of 
Bound Brook, died of phthisis pulmonalis. 

A. L. STILLWELL, Reporter. 
Somerville, N. J., June 11, 1893. 



SUSSEX COUNTY. 

To the Chairman of the Standing Committee, &c. : 

The general health of our County for the past year 
has been remarkably good — in fact almost distressingly 
healthy. No epidemics of any account have been re- 
ported. A few mild cases of " la grippe," scarlatina and 
pertussis. 

The general sanitary condition of the County seems to 
be good, and some sanitary improvements are reported. 



246 MEDICAL SOCIETY OF NEW JERSEY. 

Out of a total membership of the Medical Society of 
this County of twenty-four, only six were kind enough 
to fill out the reports so kindly furnished by the Stand- 
ing Committee and return them to the reporter, con- 
sequently his report must necessarily be short. The fol- 
lowing were the reports as received : 

^^ La gripped — Dr. Jacobus reports "ci few mild cases, 
with complications generally of a renewal of old dis- 
orders of mucous membranes and sometimes of the 
spinal nerves and muscles." 

Dr. Moore reports "few cases, mild, complicated with 
diarrhoea ; no deaths.** 

Dr. Miller, of Newton, reports: "Beginning of the 
year quite extensive ; complications of pneumonia and 
bronchitis ; mortality light.*' 

Dr. Allen — " No fatal cases of * la grippe.* ** 

Dr. Wolfe — " Have had a number of cases of * la 
grippe,* mostly during April, of mild form ; no deaths.** 

Dr. Straley — " Few mild cases, complicated with pneu- 
monia and bronchitis ; no deaths.** 

Scarlatina, — Dr. Moore reports ** a few mild cases.** 

Dr. Allen — "A few mild cases; spread was prevented 
by disinfection and quarantine.** 

Dr. Wolfe — " Had a few isolated cases in the fall ; all 
of mild form and no deaths.** 

Your reporter had three cases in one family, but by 
quarantine and plenty of disinfection, the contagion did 
not spread. The attack was mild, of about ten days 
duration, with no deaths. 

Rubeola, — Dr. Straley, only, reports "a few mild cases; 
no complications ; no deaths.** 

Diphtheria, — Dr. Miller, of Newton, reports " a few 
cases, generally mild ; one case of malignant type, died 
in three days.** 



REPORTS OF DISTRICT SOCIETIES. 247 

Cholera infantum, — Dr. Miller, of Newton, reports 
" but little, of mild type ; no deaths." 

Dr. Wolfe — ** Quite a number of cases; some very 
severe ; no deaths." 

Dr. Straley — " Few cases, medium type, complicated 
with convulsions ; no deaths." 

Your reporter had a few mild cases of cholera infantum, 
with no fatality. 

Typhoid fevjer. — Dr. Wolfe, only, reports ** three cases. 
Of the three, only one died and he had been addicted to 
the use of intoxicating liquors; death was due to heart 
failure." 

Intermittent and Remittent Fevers, — Drs. Miller, Wolfe 
and Straley, report ** a few mild cases ; no deaths." 

Pneumonia. — Dr. Miller reports '* a few cases last 
spring, of severe form ; no deaths." 

Dr. Allen — " Few cases ; only one proving fatal." 

Dr. Straley — *'Ten cases; medium type; one fatality; 
the one which proved fatal was an asthmatic with hyper- 
trophied heart and cavity in lung apex." 

Your reporter had a number of cases, and of the differ- 
ent types, one case of the catarrhal form proving fatal in 
a child of three years, in about thirty-six hours. 

Dr. Straley reports "twelve severe cases of nervous 
prostration with various complications." 

Dr. Miller, of Newton, would arrest the spread of. 
cholera after its first appearance by " strict quarantine of 
patient and perfect sanitary regulations." 

Dr. Straley would prevent cholera by " strict quaran- 
tine and perfect cleanliness," and would arrest its spread 
by "isolation of patient, destruction by fire of all the 
belongings, and liberal use of antiseptics about patients 
treated." 

Your reporter has had one case of sudden death due 



248 MEDICAL SOCIETY OF NEW JERSEY. 

to acute pneumonia, as noted under pneumonia ; no post- 
mortem was held. 

Under heading No. 6, Dr. Straley reports " a case of 
Dupuytren's contraction which was cured by a long splint 
and extension by rubber adhesive plaster. Dr. Abbe 
says this disease is only cured by operation." 

In answer to question No. 7, Drs. Straley and Miller, 
of Newton, both claim to have found a specific for per- 
tussis in thymus serpyllum. 

Under same question, Dr. Allen says: "Anti-kamnia, 
phenacetine and sulfonal have fully maintained their 
reputation in my hands, and, I believe, have won a place 
in the armamentarium of our profession." 

Dr. Jacobus says he has treated several cases of in- 
cipient phthisis successfully, but has no time to give a 
description of his course of treatment, other than cor- 
recting the secretions. I think the doctor would greatly 
benefit mankind if he would publish his plan of treat- 
ment in full. 

. L. C. BURD, Reporter. 

Ogdensburg, N. J. 



UNION COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

The amount of sickness in Union County has been 
much less than for several years. Outside of the mild 
epidemic of influenza, the past winter has been an ex- 
tremely healthy one. 

My report will be based upon replies received from 
physicians residing in our larger cities and towns in the 
County. 



REPORTS OF DISTRICT SOCIETIES. . 249 

Reports received from Elizabeth place the city in a 
fairly healthful condition. Their local board of health 
have passed a code of sanitary plumbing. La Grippe 
has prevailed to a moderate degree and complications 
fewer than in former years. 

Dr. J. S. Green reports six cases of tracheotomy per- 
formed in Elizabeth during the winter of 1892 and 1893, 
with two deaths. Cholera infantum very prevalent in 
summer of 1892. Last year one case of typhoid fever, 
with three distinct relapses, lasting over three months 
recovery. One case lobar pneumonia, with rectal tem- 

* 

perature of 106 degrees for three days. 

Dr. N. L. Wilson speaks highly of sulfonal in delirium 
tremens and neurasthenia ; also phenacetine in reducing 
temperature, even in a weak heart, without any bad 
effect. 

From Plainfield, Drs. Endicott and Long write health 
of city fairly good. " La Grippe *' quite prevalent, but 
of much milder type than in previous years. 

Dr. Long speaks well of iatrol, as an antiseptic, and 
oxygen gas in pneumonia, chronic bronchitis and night 
sweats of phthisis. 

From Westfield, Dr. J. B. Harrison reports " la grippe " 
with tonsillitis and pneumonia as complications ; the lat- 
ter complication attacking the left side only. Remittent 
fevers, protracted in their duration, regardless of the 
therapeutic measures used, and a decided tendency to 
malarial fevers generally. Tonsillitis unusually prevalent, 
both simple and follicular. He notes the fact of the 
severity with which miasmatic diseases attack and pros- 
trate elderly people. 

Rahway, as all other places, was visited by what 
seems to be our annual visitor, la grippe. It seems it has 
come to stay. During March and April the extent was 



250 MEDICAL SOCIETY OF NEW JERSEY. 

considerable ; type mild ; complications fewer. Scarlet 
fever, only a few sporadic cases, mild in character; no 
diphtheria; typhoid fever, a few cases, and, with one 
exception, of a mild type. 

Our local board of health has taken the "bull by the 
horns," and appointed an additional health inspector 
whose duty it is to make a house-to-house inspection and 
report to the board, which meets semi-monthly, all 
nuisances, etc. The board acts promptly in abating all 
such nuisances. 

The sanitary condition of Rahway is nearly perfect. 

Dr. Silvers, of Rahway, speaking of cholera, says: 
" Place in the hands of everyone, easily understood, 
condensed hygienic laws, as to the well-cooking of, and 
specify the kinds of food ; see that every house and yards 
are in good sanitary condition. Plumbers are not good 
judges of the sanitary condition of their own work; have 
each house-wife disinfect nightly all sinks and privies ; 
drink and only use water that has been boiled.*' 

All reports advise perfect quarantine against infected 
location, isolation, sanitation and disinfection and exclu- 
sion of foreign emigration. 

Under special cases, Dr. G. W. Endicott, of Plainfield, 
has performed one colotomy for cancer of uterus, v^hich 
was successful. The patient was in a state of collapse 
from retention of feces; improved quickly and is very 
comfortable now, one year after operation. Also has 
operated twice for ovarian tumors ; both successful ; 
patients completely recovered and in perfect health. 

Dr. M. B. Long, of Plainfield, reports one case of 
tracheotomy, which died ; also a case of plastic surgery 
for correcting deformity of the upper eye-lid ; successful 
after the fourth sitting, lasting over a period of twelve 
weeks. 



REPORTS OF DISTRICT SOCIETIES. 251 

Dr. J. S. Green, of Elizabeth, reports a case of lateral 
(left) lithotomy: recovery. One tracheotomy for diph- 
theritic laryngitis ; recovery. Two cases of compound 
multiple fractures of both bones of leg, treated asep- 
tically ; recovery in both cases without pus. 

H. PAGE HOUGH, Reporter, 
Rahway, N. J., June 3, 1883. 



WARREN COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

The past year, for Warren County, has been excep- 
tional, as regards the general health of the inhabitants 
thereof. We have had, virtually, no epidemics, and, 
therefore, find very little to interest the medical profes- 
sion throughout the State. 

" La grippe *' has prevailed in a light form in some 
sections, but taking on the conditions of mild influenza, 
and only proving serious when complicated with other 
disorders of a low type. 

Scarlatina has only been local in its prevalence, with 
an occasional death. 

Rubeola has scarcely been heard of. 

Cholera infantum appeared as usual in the larger towns 
where there were bad sanitary surroundings, in the sum- 
mer of 1892, but very few fatal cases. 

There have been a few sporadic cases of typhoid fever, 
but of a mild type, as a rule. 

Diphtheria obtained a very poor foothold in the County 
during the past year. There were a few cases in Phillips- 
burg with two or three deaths, while our neighbors across 
the Delaware river, in Easton, Pa., have contended with 
the disease in a malignant and fatal form. 



252 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Stites, of Washington, reports two malignant and 
fatal cases in his practice, and Dr. Johnson, of Blairs- 
town, reports a fatal case with laryngeal complications. 

Thus far I have only received reports from three of 
the twenty members of our District Society, on the 
unique and comprehensive blanks sent out by your 
Committee. 

Dr. Johnson reports "an unusual number of sudden 
deaths ** in his locality, ** without previous medical at- 
tendance," caused by apoplexy, or cardiac affection/; no 
post-mortem. 

To prevent the introduction of cholera into a com- 
munity. Dr. Stites would observe " strict quarantine and 
cleanliness ; and to arrest its spread after its first appear- 
ance, he would " isolate with cleanliness and burn all 
excrements.*' 

In the same line. Dr. G. Wyckoff Cummins, of Belvi- 
dere, besides quarantining all suspects, he would, so far 
as possible, " kill all germs by heat, in everything the 
individual takes into his body, in the form of food or 
drink.'* To arrest the spread of cholera, he would use 
** intestinal antiseptics, of which a number are efficient 
and may be taken in doses sufficient to act as germicides.'^ 

Warren County is becoming famous as a resort for 
invalids and those who desire to recuperate their phy- 
sical vitality and are unable to visit high-priced resorts. 

J. H. GRIFFITH, Reporter. 

Phillipsburg, N. J., May 31, 1893. 



41 

The Chairman of the Standing Committee deeply 
regrets that, owing to circumstances beyond our control, 
the essay of Dr. William Elmer, Third Vice President, 
instead of being printed among the essays, has neces- 
sarily been placed at the end of the volume ; that the 
obituary of Dr. James S. Green, Sr., was also received 
too late for insertion in its proper place ; also that 
repeated correspondence has failed to secure full obituary 
notices of other deceased members, and in some instances 
even the dates of their death. The delay in the date of 
issue of the Transactions this year is owing largely to the 
extended absence from home of some of the authors of 
papers, to whom proof sheets were sent for correction. 



ESSAY. 



BY WM. ELMER, M. D., THIRD VICE-PRESIDENT, TRENTON, N. J. 



The Quarantine of Cholera. 

The subject of quarantine, in its relation to cholera, is 
one that comes closely home to each and every one of 
us, both as professional men and as individuals. We all 
felt its profound importance last summer, when a fleet of 
transatlantic steamers lay within sight of our great 
metropolis, each containing cases whose infection might 
at any moment produce an outbreak of dire disease, the 
ravages of which once started might invade not only the 
inhabitants in proximity to those shores, but be spread 
broadcast over this whole land, until the crv of woe and 
desolation would come up from every section of its sixty 
millions of inhabitants. The people waited day by day 
with bated breath. The newspapers were hourly scanned 
by an eager multitude to learn the latest developments 
and results. Every incoming vessel was also eagerly 
awaited to know her death list, or the fate of those on 
board, from this dreaded pestilence. It was a time of 
anxious suspense to all, to physicians as well as to the 
people. But as hour after hour passed, and notwith- 
standing fresh arrivals of steamers daily, till near a score 
of ships lay in detention, yet no foothold seemed to be 
gained, no outbreak on land occurred ; the few cases on 
shipboard were confined to quarantine hospitals, and no 
epidemic developed. The people then began to breathe 
more freely, and the pall of destruction which had so 
darkly menaced us was gradually removed; hope and 



2S6 MEDICAL SOCIETY OF NEW JERSEY. 

confidence began to be restored, and all felt that an 
imminent and fearful plague had been averted. Yes, if 
ever sanitary science achieved a victory more signal and 
sweeping than ever fell to earth's greatest conquerors, it 
was when, by the knowledge and skill and vigilance of 
those medical men in charge of affairs, the spectre of 
cholera was kept out of New York city and vicinity last 
summer and autumn. God be thanked for what he gave 
man — knowledge to discern, skill to detect and power to 
perform. Had not the recently acquired knowledge of 
bacteriology, the discovery of the cholera germ, the 
laws of its propagation and of its extinction, the means 
and methods of protective antisepsis — had not these and 
other correlated facts been known to medical men — had 
we only known the nature of cholera as we knew it less 
than two decades ago, those few intrepid quarantine 
physicians could never have held this grim monster at 
bay with their magistral wand, or the fiat, "thus far shalt 
thou come and no farther," could never have been effec- 
tively uttered. The resources of the State were freely 
placed at their disposal, and the aid of the national 
government was likewise proffered to assist their assid- 
ious efforts to stamp out the disease and limit its propa- 
gation. Success crowned their efforts. The plague was 
stayed. 

But one forcible lesson taught our people and our law 
makers, was the fact that our present quarantine regula- 
tions were insufficient for our adequate protection, and 
that a national quarantine system should co-operate with, 
and yet be paramount to those measures in vogue and 
adopted by the several states. The popular voice reached 
the ears of senators and representatives in congress, and, 
through the efforts of Isham G. Harris, of Tennessee, a 
national law has now been enacted which, goes farther 



ESSAY. 257 

than ever before to protect us from the foreign invasion 
of any deadly disease, and gives us a much greater assur- 
ance of safety, in that it begins its quarantine protection 
where it ought — with the out-going vessel at the foreign 
port. It is far easier to prevent a disease by forbidding 
its inception from abroad than to control it after having 
arrived at our own shores. Every emigrant, by this 
regulation, is inspected before he puts his foot on board, 
as to his being a possible carrier of contagion, and both 
he and his baggage must be free from possible contam- 
ination before he is allowed to embark. 

The main features of the national law on quarantine, 
known as the *' Harris bill," passed by congress February 
15, 1893, are, in brief, as follows: 

"An act granting additional quarantine powers and 
imposing additional duties upon the Marine Hospital 
Service." 

Section i imposes a fine of $5,000 for any ship or 
vessel violating the provisions of this act by entering or 
attempting to enter any port of the United States, 
except as in accordance with the provisions of the 
national, state and municipal regulations. 

Section 2 requires every vessel clearing from any 
foreign port, to obtain from the consul or other proper 
official, a bill of health, setting forth the sanitary history 
and condition of said vessel, and that it has in all re- 
spects complied with the rules required as to its cargo, 
passengers and crew ; that the medical inspector must be 
satisfied in his own mind that the statements are true ; 
and a fine of $5,000 is likewise entailed upon the vessel 
sailing from port without such bill of health, to be re- 
covered in the proper District Court of the United 
States. * 

Section 3 requires the surgeon-general of the Marine 
3 7 



258 MEDICAL SOCIETY OF NEW JERSEY. 

Hospital Service to co-operate with and aid state and 
municipal boards of health in the enforcement of rules 
and regulations ftmade to prevent the introduction of 
contagious or infectious diseases into the United States 
from foreign countries, and into one state or territory 
from another (making it interstate as well as interna- 
tional.) Or, if present state or municipal quarantine 
regulations are not sufficient in the opinion of the Sec- 
retary of the Treasury, he is authorized to make them 
so, and the President is empowered to execute and 
enforce them if necessary. 

Section 4 makes it the duty of the supervising sur- 
geon-general of the Marine Hospital Service to make 
weekly reports of the sanitary condition of the foreign 
ports where contagious diseases may exist. 

Section 5 requires the master of the vessel to deliver 
to the collector of customs, at his port of entry, the said 
bills of health obtained from the consul at the port of 
departure. 

Section 6 gives power to the Secretary of the Treasury 
to remand any infected vessel, at its own expense, on its 
arrival at any port not provided with proper quarantine 
facilities, to any regular quarantine station, until certified 
that it is free from danger of infection. 

Section 7 grants to the President the right, in the 
interest of the public health in emergencies, " to prohibit 
in whole or in part, the introduction of persons or 
property from cholera-infected districts, for such period 
of time as he may deem necessary.** 

Section 8 warrants the payment, by the United States, 
for buildings, etc., surrendered by any state to the 
national government for use in time of necessity. 

Section 9 repeals previous acts not in conformity with 
this bill. 



ESSAY. 259 

In accordance with this act of congress, a circular has 
been issued by the Treasury Department at Washington 
to consular and medical officers of the United States 
serving in foreign ports, relating to the labeling of 
baggage and the issue of inspection cards to steerage 
and cabin passengers, as follows : 

" It is hereby ordered, that until further notice, all 
baggage of steerage passengers destined for the United 
States shall be labeled. If the baggage has been in- 
spected and passed, the label shall be a red label, bearing 
the name of the port and the steamship, the word 
* inspected^ in large type, with date and the seal of the 
consulate. All baggage that has been disinfected shall 
be pasted with a. yellow label, with the word ^disinfected' 
in large type, the steamer, the port and the date, affixed 
with the consular seal. Each immigrant or steerage 
passenger is also to be furnished with an inspection card 
of prescribed form, on which is inscribed his name and 
residence, the port of departure, steamer and date, 
properly stamped ; to be retained by him until he reaches 
his destined landing, and there presented to the quaran- 
tine officer and to the health officer of the several states 
through which he may pass. Instructions in several 
different languages are printed on the reverse of this 
card, to the immigrant, to retain this card to his destina- 
tion, in order to avoid detention. It is issued to every 
member of a family, as well as to the head thereof. 
Cabin passengers from cholera ports, and their baggage, 
are also given a special inspection card, duly prepared, 
certified and stamped with the consul's official seal." 

As will readily be perceived, this is by far the best, 
the most far-reaching plan of quarantine that this country 
has ever realized, the most thorough, the most compre- 
hensive. And this, combined with our present state and 



26o MEDICAL SOCIETY OF NEW JERSEY. 

municipal systems, affords us the best devised protection 
for the populace, and the least detention and derange- 
ment of maritime commerce. There is compulsory regu- 
lation on the other side; co-operation and concert of 
action between the city, the state and the nation, on 
this. It is a quarantine of sanitation, not of detention. 
For cholera is pre-eminently a quarantinable disease. It 
is not indigenous, but always imported. Every epidemic 
has demonstrated the fact that it has been unmistakably 
traceable to the arrival of immigrants infected in person, 
clothing, or household goods. It is the crowded and 
filthy caravans of pilgrims from the Ganges, or the 
crowded pilgrim steamer or passenger vessel, which in- 
troduces it from Bombay or Calcutta, into Europe. It 
was the packed troop-ship and transport which brought 
the contagion from Egypt into France. It is the steer- 
age of the immigrant vessel to our own shores, with its 
crowd-poison, and specific infection, which we have to 
fear. And these, we believe, are now met by national 
and state legislation, as they have never been before. 
The national government has responded to national duty 
for popular protection ; and that, too, with the minimum 
interference of maritime commerce. Just now, as Dr. 
Rauch truly says, " this means more than the good to be 
found in the saving of human life, and in avoiding the 
suffering and misery, the ruined homes and desolated 
families which an epidemic always leaves in its track. It 
means the prevention of panic ; it means the prevention 
of the interruption of trade and import ; it means the 
prevention of the loss of millions of dollars; all of 
which would inevitably result from an epidemic of Asiatic 
cholera in this country." A single outbreak in New 
York or Chicago, at present, would cause pecuniary loss 
and public disaster of incalculable magnitude. But with 



ESSAY. 261 

an efficient and feasible quarantine system, by land and 
by sea, and along the great highways of travel, with our 
present knowledge of the laws and mode of propagation 
of cholera culture, the chances of its attaining any great 
proportions as an epidemic are exceedingly small. This 
should go far to allay public excitement and inspire 
public confidence. 

As to the mode of handling infected vessels — their 
manner of disinfection, the specially-constructed equip- 
ments for introducing sulphur fumes, superheated steam 
or various medicated solutions into baggage and goods, 
the treatment of the sick and the deportation of the well 
for detention into temporary quarters, are matters of 
great interest, but are so well understood and so fully 
carried out at stations, that in this limited article we 
feel that we cannot enter into further details. 

But the quarantine of cholera must involve protection 
by land as well as by sea. It is not simply to provide for 
keeping it away from the coast-line, but all our interior 
states and cities are entitled to equal safeguards. And 
here we find, perhaps, even greater vigilance and care 
necessary than for a quarantine by sea. The rapid con- 
veyance by railroad, of infected persons or baggage, may 
transmit a case far into the interior, and scatter the 
germs of disease en route, .almost before the health 
authorities are aware of its presence. 

If a quarantine is vigorously carried out, it is so apt to 
be denounced as cruel and barbarous; if loosely en- 
forced, it is certainly ineffective, and likely to give rise to 
the ** shot-gun " policy as a relief, by the panic-stricken 
inhabitants of the threatened district. Yet it is un- 
doubtedly incumbent upon state and municipal authori- 
ties, to put a ** cordon sanitaire ** around every place 
whence a focus of disease may be propagated. The 



262 MEDICAL SOCIETY OF NEW JERSEY. 

isolation of the sick, the detention of suspects, the fumi- 
gation of clothing or apartments, the inspection of rail- 
road stations, cars, ferries, depots, manufactories and 
tenements, and all precautions of general sanitation, 
should be rigorously enforced. 

The liberty of the few must always yield to the 
welfare of the multitude. 

Municipal quarantine, too, is all-important in the pre- 
vention of the invasion of cholera or of any fatal 
epidemic, since it is in the crowded and filthy corners of 
our cities that we naturally look for the first outbreaks of 
disease. The locality to which the disease germ is 
brought is of the utmost importance as to its arrest and 
control. In the city, the police and health departments 
should work in unison. Sanitary officers should have 
command of every district. Reception hospitals should 
be provided with special attendants on duty. House-to- 
house inspection, pure food and water supply, street 
cleansing, sewer flushing, and all the details of sanitary 
police work, should be diligently attended to. Public 
funerals of cholera patients interdicted, and all matters 
of personal prophylaxis, as well as public hygiene, should 
be brought under the most scrupulous care and super- 
vision. As Surgeon-General Wyman of the United 
States Marine Hospital Service says, in a recent number 
of The North American Review: "Cholera seeks by 
natural choice, denizens of unsankary situations; those 
with clean environments, and simple precautions looking 
to avoidance of close proximity or contact with infected 
persons or materials, may feel reasonably assured of 
safety. The germ is found in the vomited matter and 
bowel discharges of cholera patients, and persons having 
immediate care of cases should remember that the safe- 
guard is again and again, scrupulous attention to the 






/ 



ESSAY. 263 

cleanliness of the hands, which are the vehicles of trans- 
porting the germ from the sick to the well." Cholera 
poison is always taken into the system by the mouthy 
through the cholera bacillus. It is not absorbed by 
breathing, or in any other way; neither is it infectious or 
contagious, as is yellow fever or variola. Prophylaxis,, 
therefore, is easy. 

In this brief essay we have considered cholera quaran- 
tine by sea, by land and by municipal effort. We are 
better prepared, without doubt, to resist its invasion 
to-day tha'n ever before, both from an understanding of 
its cause and pathological nature, and from our more 
complete and scientific methods of stamping it out and 
modifying its virulence. And yet We need far greater 
advances still in our quarantine methods. We are far 
behind England in our efficiency and perfection. True, 
her territory is small, not much more than one-fifth the 
area of Texas, but her sanitary measures and regulations 
are of the most united and determined character, well 
worthy of imitation here. In this country, instead of 
the various sea-coast states maintaining a separate ser- 
vice, with each one's policy under the dictation, possibly, 
of an autocratic or inefficient officer, the general govern- 
ment itself should have absolute control and responsi- 
bility of inspection. We would advocate, still further, an 
international quarantine service, for as cholera concerns 
all nations alike, each should take its part in adopting 
proper exclusive measures for its own protection, and 
also in exterminating the plague at its source — the delta 
of the Ganges. Were this latter accomplished, cholera 
would be swept from the face of the earth. We de- 
voutly hope that at no distant day this may be a 
realization. 

But what this country especially needs is a National 



264 MEDICAL SOCIETY OF NEW JERSEY. 

Board of Health, or a National Health Bureau, with plenary- 
powers in the matter of national maritime and interstate 
quarantine. Our views are fully in accord with the 
thoughtful suggestions of Dr. T. Mitchell Prudden, in a 
recent article in one of our popular magazines. He says : 
" A great central bureau of health, in which administra- 
tion, instruction, research and record in matters concern- 
ing the public health should centre, and to which, in 
stress, local authorities could turn for help and counsel ; 
a department, which, representing the sanitary and hy- 
gienic interest of this great nation, could make common 
cause with similar departments long since established in 
other lands, against the ravages of disease — such a bureau 
of health is urgently ne.eded in the United States to-day, 
and should soon be established." Let this bureau have 
its headquarters at our national capital, let it be organized 
in connection with the treasury department, that it may 
secure the needed financial support, let its component 
executive department include tlie surgeon-generals of the 
army, the navy and the Marine Hospital Service, whose 
position, training and discipline in these various arms of the 
public service well qualify them for such important ad- 
ministrative duties, and would merit the confidence and 
support of the public ; men who are removed from all 
private factions or interests, from the selfish greed of 
politicians, and whose single aim would be the public 
welfare and efficient service in its behalf. An advisory 
board of skilled sanitarians and physicians of repute 
should be appointed in addition by the President, repre- 
senting the different sections of our country — north, 
south, east and west ; and these should comprise a board 
with full legislation and executive powers to devise pro- 
tective measures which would serve the interests of the 
entire population. State and local quarantines might 



ESSAY. 265 

then probably be abolished or, if continued, hold but a 
subordinate and dependent position ; but no interference 
should be made with state or local boards of health as 
they now exist, since through their efforts and vigilance 
in communities they form not only powerful coadjutors 
in obtaining information and disseminating sanitary prin- 
ciples, but likewise act as potent agencies in carrying out 
the regulations and enforcing the laws of such a central 
organization in every township and hamlet in the land. 
But we believe that this general system of maintaining a 
National Bureau of Health, founded on this plan, with 
such modifications as the test of experience and the 
exigencies of possible emergencies may indicate, is the 
most feasible and the most desirable that can be insti- 
tuted, and will result in protecting this great nation from 
sweeping pestilences, disastrous panics and commercial 
losses. 

What a glorious achievement would it be for sanitary 
science to develop such happy results. It can be done. 
It will be done. Let us, therefore, as men most con- 
cerned in this humane and noble effort, unite in urging 
by our action, our precept and our influence, in public 
and in private, by tongue and by pen, that happy con- 
summation which will be fraught with blessing to this 
whole people and will receive the plaudits of all man- 
kind. 



OBITUARY. 



•^^^^^- 



JAMES S. GREEN, Sr., M. D. 

BY N. L. WILSON, M. D. 

James S. Green, A. M., M. D., was bom at Princeton, N. J., July 
22, 1829. He was the son of James S. Green and grandson of the 
Rev. Ashbel Green, of Princeton College. He was graduated 
from that college in June, 1848, and engaged in the study of medicine 
at Philadelphia, with Dr. John Neill. He was graduated at the 
Medical Department of the University of Pennsylvania with high honors 
in April, 1851. He was resident physician for eighteen months at the 
Wills' Hospital for Diseases of the Eye and Ear, and for three years 
was assistant demonstrator of anatomy in the University of Pennsyl- 
vania. He went to Elizabeth in November, 1853, and at once attained 
the front rank in his profession there. Dr. Green was for four years 
one of the Board of Managers of the Morris Plains Lunatic Asylum. 
He was one of the founders of the Elizabeth General Hospital and 
Dispensary, and was president of the staff of that institution at the 
time of his death. He was also instrumental in the establishment of 
a training school for nurses, and was its first lecturer on surgical 
emergencies. He practiced medicine and surgery in the City of Eliza- 
beth for nearly forty years, and his skill and wisdom in his profession 
secured him a name, not only in Elizabeth and vicinity, but his ability 
was recognized and appreciated among the best medical talent in this 
state and New York. Being a public-spirited citizen, he did much to 
advance the interests of the community in which he lived. He was 
chosen the first president of the city council when Elizabeth became 
a city, and served several times in that body. He was elected mayor 
of Elizabeth in 1877 and served one year. A man of strong person- 
ality, his word and example carried weighty influence in public affairs 
as well as in private. He was a strong and faithful friend, but just 



OBITUARY. 267 

even to those with whom he disagreed. With his loyalty to his pro- 
fession he was ever faithful to the sacred work of alleviating suffering, 
and his gentle qualities of mind and heart added to his ability, made 
him a friend in sickness and in health. 

He was prominent in Masonic circles and at the time of his 
death was the oldest Past Master of Washington Chapter, and a 
member of the Grand Lodge of New Jersey. 

He had just returned from the annual convention, at Atlantic City, 
of the State Medical Society, and was feeling somewhat improved in 
health, but was stricken suddenly on the afternoon of July 2, 1892, 
with oedema of the lungs. Dr. Green was elected President of the State 
Medical Society in 1 890, and on retiring from that office, delivered at 
the annual meeting, at Long Branch, in 1891, an able address entitled 
"A View of Modern Surgery from the Standpoint of a General 
Practitioner" (see Transactions of 1891, pages 63 to 82). Dr. Green 
was also a permanent member of the American Medical Association. 



CONTENTS. 



PAGE. 

OFFICERS 4 

FELLOWS 5 

HONORARY MEMBERS 7 

PERMANENT DELEGATES 8 

MEMBERS OF DISTRICT SOCIETIES 9 

SUMMARY OF MEMBERS 22 

MINUTES 23 

APPENDIX TO THE MINUTES— 

Report op Corresponding Secretary 69 

Report of Treasurer 70 

ADDRESS BY THE PRESIDENT 73 

ESSAYS— 

Salpingitis and Pelvic Adhesions, by H. G. Wetherill, M. D.. loi 
Some Thoughts on Symptoms and Diagnosis, by Samuel E. 

Armstrong, M. D iii 

Supra- Vaginal Hysterectomy for Fibroid, by H. G. Wetherill, 

M. D 123 

Bovine Tuberculosis— Its Transmission to Man and How 

TO Prevent It, by Joseph William Stickler, M. D 129 

Present Status of Legislation for the Prevention of 

Blindness, by Walter B. J[ohns9n, M. D 143 

The Quarantine of Cholera, by William Elmer, M. D 255 

REPORT OF STANDING COMMITTEE 155 

IN MEMORIAM 173 

OBITUARIES— 

J. Linn Allen, M. D 177 

Lorenzo Welton Elder, M. D 177 

Enoch Fithian, M. D 179 

James S. Green, Sr., M. D 266 

John Pindar, M. D 180 

William N. Pindell, M. D 181 

J. Barron Potter, M. D 181 

William Shipman, M. D 184 

William A. Smith, M. D 184 

William Coolidge Stone, M. D 185 

Beriah Andrew Watson, M. D 186 

Carlisle B. Weeks, M. D 190 

Seymour Westcott, M, D 191 



270 CONTENTS. 

PAGE. 

REPORTS OF DISTRICT SOCIETIES- 
ATLANTIC COUNTY, Report by H. C. James, M. D 193 

BERGEN COUNTY, Report by S. E. Armstrong, M. D 195 

Pyelitis— Operation, by John A. Wells, M. D 197 

BURLINGTON COUNTY, Report by Wm. H. Shipps, M. D. . . . 198 

CAMDEN COUNTY, Report by Daniel Strock, M. D 200 

CUMBERLAND COUNTY, Report by M. K. Elmer, M. D 210 

ESSEX COUNTY, Report by T. W. Corwin, M. D 211 

GLOUCESTER COUNTY, Report by S. F. Ashcraft. M. D 218 

A Case of Carbolic Acid Poisoning, by Drs. J. H. and S. 

F. Ashcraft 223 

HUDSON COUNTY, Report by J. A. Exton, M. D 225 

Cases, by Fred. M. Corwin, M. D 226 

HUNTERDON COUNTY, Report by G. N. Best, M. D 227 

MERCER COUNTY, Report by C. F. Adams, M. D 230 

Pneumonia— Sudden Death, by Cornelius Shepherd, M. D.. 232 

Alcoholic Paralysis with Fatal H^matemesis, by J. 

M. Shepherd, M. D 232 

MIDDLESEX COUNTY, Report by A. Van Nest Baldwin, M. D. 233 

MONMOUTH COUNTY, Report by F. C. Price, M. D 235 

MORRIS COUNTY, Report by E. P. Cooper, M. D 239 

OCEAN COUNTY, Report by I. W. Kirk, M. D 241 

PASSAIC COUNTY, Report by J. W. Atkinson, M. D 242 

SALEM COUNTY, Report by W. S. Patrick, M. D 243 

SOMERSET COUNTY, Report by A. L. Stillwell, M. D 244 

SUSSEX COUNTY, Report by L. C. Burd, M. D 245 

UNION COUNTY, Report by H. Page Hough, M. D 248 

WARREN COUNTY, Report by J. H. Griffith, M. D 251 



The Medical Society of New Jersey does not hold 
itself responsible for the sentiments expressed by the 
authors of papers; nor for the reports of clinical cases 
furnished by the reporters of the District Societies. — 
Transactions^ i8j6y page j8. 



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